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免疫功能正常的年轻男性巨细胞病毒性视网膜炎

Cytomegalovirus Retinitis in Immunocompetent Young Male.

作者信息

Ghani Eijaz, Noor Misbah, Khalid Saadiya

机构信息

Department of Virology, Armed Forces Institute for Pathology, Rawalpindi, Pakistan.

出版信息

J Coll Physicians Surg Pak. 2017 Sep;27(9):S137-S138.

Abstract

Cytomegalovirus (CMV) retinitis is a sight-threatening form of posterior uveitis affecting patients with Acquired Immunodeficiency Syndrome (AIDS), especially those with CD4 count <50 cells/mm3. There are few reported cases of CMV retinitis in patients with CD4 count >100 cells/mm3. Avirostatic agent like Ganciclovir has good response rate when given as intravitreal injection. Here, we report a case of CMV retinitis in a young immunocompetent male who presented with history of progressive loss of vision in both eyes despite receiving oral and intra-vitreal steroids. At the time of diagnostic testing, there was no history of high dose immunosuppressant therapy. CMV infection was confirmed by Polymerase Chain Reaction (PCR) for viral deoxyribonucleic acid (DNA) testing. Physicians treating such cases should take into account infectious causes of retinal vasculitis before starting anti-inflammatory therapy. Proper diagnosis should precede the treatment as far as possible.

摘要

巨细胞病毒(CMV)视网膜炎是一种威胁视力的后葡萄膜炎,影响获得性免疫缺陷综合征(AIDS)患者,尤其是那些CD4细胞计数<50个/mm³的患者。CD4细胞计数>100个/mm³的患者中报告的CMV视网膜炎病例很少。像更昔洛韦这样的抗病毒药物玻璃体内注射时具有良好的有效率。在此,我们报告一例年轻免疫功能正常男性的CMV视网膜炎病例,该患者尽管接受了口服和玻璃体内类固醇治疗,但仍有双眼视力进行性丧失的病史。在诊断测试时,没有高剂量免疫抑制治疗史。通过聚合酶链反应(PCR)进行病毒脱氧核糖核酸(DNA)检测确诊为CMV感染。治疗此类病例的医生在开始抗炎治疗前应考虑视网膜血管炎的感染原因。应尽可能在治疗前进行正确诊断。

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