免疫抑制患者的内源性诺卡菌性眼内炎：一种对潜在危及生命和致盲疾病的严重警示。
Endogenous Nocardial Endophthalmitis in an Immunosuppressed Patient: A Serious Warning of an Underlying Life Threatening and Blinding Disorder.
作者信息
Trehan Hemant, Kaushik Jaya, Jain Vaibhav Kumar, Parihar Jitendra Kumar Singh, Avasthi Abhijit
机构信息
Department of Ophthalmology, Army Hospital Research and Referral, Delhi Cantonment, India.
Department of Ophthalmology, Army Hospital Research and Referral, Delhi Cantonment, India; Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
出版信息
J Ophthalmic Vis Res. 2017 Jan-Mar;12(1):113-116. doi: 10.4103/2008-322X.200172.
PURPOSE
To report a case of bilateral endogenous nocardial endophthalmitis with central nervous system involvement in an immunocompromised individual with an extremely poor outcome.
CASE REPORT
A 35-year-old man with a history of long-term, prescribed oral steroid use for membranoproliferative glomerulonephritis presented with profound bilateral vision loss. Patient's diagnosis of bilateral endogenous nocardial endophthalmitis was delayed. Nocardia was finally isolated from a brain biopsy after a repeat magnetic resonance imaging revealed a brain abscess. With anti-nocardia therapy, patient improved systemically, but the visual outcome was poor, with no light perception in both eyes.
CONCLUSION
Ocular nocardiosis is a serious vision and life threatening disorder, particularly in patients on immunosuppressive therapy. A high index of suspicion is required for successful treatment.
目的
报告一例免疫功能低下个体发生的双侧内源性诺卡菌性眼内炎并累及中枢神经系统，预后极差。
病例报告
一名35岁男性，有长期因膜增生性肾小球肾炎而服用处方口服类固醇的病史，出现双侧严重视力丧失。患者双侧内源性诺卡菌性眼内炎的诊断被延误。在重复磁共振成像显示脑脓肿后，最终从脑活检中分离出诺卡菌。经过抗诺卡菌治疗，患者全身状况有所改善，但视觉预后较差，双眼均无光感。
结论
眼部诺卡菌病是一种严重威胁视力和生命的疾病，尤其是在接受免疫抑制治疗的患者中。成功治疗需要高度的怀疑指数。
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