棘阿米巴引起的原发性视网膜下脓肿：临床与病理病例报告及文献复习
Primary subretinal abscess caused by acanthamoeba: clinical and pathologic case report and review of the literature.
作者信息
Anderson Nicholas G, Hamler Sarah E, Duncan Lisa D
机构信息
From the *Department of Surgery, Division of Ophthalmology, Graduate School of Medicine, University of Tennessee Medical Center, Knoxville, Tennessee; †Southeastern Retina Associates, Knoxville, Tennessee; and ‡Department of Pathology, Graduate School of Medicine, University of Tennessee Medical Center, Knoxville, Tennessee.
出版信息
Retin Cases Brief Rep. 2012 Winter;6(1):37-9. doi: 10.1097/ICB.0b013e3181ff094b.
PURPOSE
To report the clinical and pathologic findings in a patient with a primary Acanthamoeba subretinal abscess.
METHODS
A healthy 40-year-old man was evaluated and treated for a subretinal abscess. A subretinal aspirate was evaluated using hematoxylin-eosin stains and polymerase chain reaction.
RESULTS
Results of the histologic examination of the subretinal aspirate demonstrated numerous Acanthamoeba cysts. The diagnosis was confirmed by polymerase chain reaction. The infection was treated with local and systemic antimicrobials. The visual acuity remained stable, and there was no local or systemic spread of the infection.
CONCLUSION
To the authors' knowledge, this is the first biopsy-proven case of primary subretinal abscess because of Acanthamoeba. Acanthamoeba should be considered in the differential diagnosis of a subretinal abscess, even in the absence of systemic or corneal symptoms. Aggressive treatment can prevent serious ocular and systemic complications.
目的
报告一例原发性棘阿米巴视网膜下脓肿患者的临床及病理表现。
方法
对一名40岁健康男性的视网膜下脓肿进行评估和治疗。使用苏木精-伊红染色和聚合酶链反应对视网膜下吸出物进行评估。
结果
视网膜下吸出物的组织学检查结果显示有大量棘阿米巴囊肿。聚合酶链反应证实了诊断。采用局部和全身抗菌药物治疗感染。视力保持稳定，感染无局部或全身扩散。
结论
据作者所知，这是首例经活检证实的由棘阿米巴引起的原发性视网膜下脓肿病例。即使没有全身或角膜症状，在视网膜下脓肿的鉴别诊断中也应考虑棘阿米巴。积极治疗可预防严重的眼部和全身并发症。
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