Sogani Julie, Ivanidze Jana, Phillips C Douglas
Albert Einstein College of Medicine, Bronx, NY, USA.
Department of Radiology, Weill Cornell Medical College at New York-Presbyterian Hospital, New York, NY, USA.
Clin Imaging. 2014 Sep-Oct;38(5):727-9. doi: 10.1016/j.clinimag.2014.02.012. Epub 2014 Feb 28.
We report a case of chiasmitis caused by a rare nontuberculous mycobacterium in an immunocompromised patient. A 44-year-old man with a history of AIDS presented with recurrent vision loss and headache. Magnetic resonance imaging (MRI) demonstrated an enhancing mass involving the optic chiasm. Histopathologic and microbiological evaluation revealed infection with Mycobacterium haemophilum. While combination antimicrobial and steroid therapy contributed to improvement in his vision, the patient's symptoms recurred. Follow-up MRI showed extension of infection to the hypothalamus and leptomeninges, indicative of basilar meningitis. MRI is a valuable tool for early diagnosis of chiasmitis as well as for monitoring infection progression and treatment response.
我们报告了一例免疫功能低下患者由罕见的非结核分枝杆菌引起的视交叉炎病例。一名有艾滋病病史的44岁男性出现反复视力丧失和头痛。磁共振成像（MRI）显示累及视交叉的强化肿块。组织病理学和微生物学评估显示感染了嗜血性分枝杆菌。虽然联合抗菌和类固醇治疗有助于改善他的视力，但患者的症状复发。随访MRI显示感染扩展至下丘脑和软脑膜，提示基底脑膜炎。MRI是早期诊断视交叉炎以及监测感染进展和治疗反应的有价值工具。
