无眶蜂窝织炎的细菌性鼻窦炎所致眶尖综合征
Orbital apex syndrome from bacterial sinusitis without orbital cellulitis.
作者信息
Pfeiffer Margaret L, Merritt Helen A, Bailey Lucy A, Richani Karina, Phillips Margaret E
机构信息
Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), 6431 Fannin St., MSB 7.024, Houston, TX, 77030, United States.
Robert Cizik Eye Clinic, 6400 Fannin St., Suite 1800, Houston, TX, 77030, United States.
出版信息
Am J Ophthalmol Case Rep. 2018 Jan 31;10:84-86. doi: 10.1016/j.ajoc.2018.01.041. eCollection 2018 Jun.
PURPOSE
To describe a case of orbital apex syndrome as a result of isolated bacterial sinusitis.
OBSERVATIONS
A 63-year-old woman presented with an orbital apex syndrome from isolated bacterial sinusitis with rapidly declining visual acuity to no light perception. We compared our case with 6 similar cases of severe vision loss from isolated bacterial sinusitis. In contrast to previously published cases, our patient presented with good vision yet deteriorated to no light perception despite appropriate treatment.
CONCLUSIONS AND IMPORTANCE
Orbital apex syndrome can present as a constellation of cranial neuropathies including optic neuropathy from conditions affecting the orbital apex. Although vision loss remained permanent, prompt initiation of broad-spectrum antibiotics and antifungals and surgical intervention prevented further extension of infection into intracranial structures.
目的
描述一例由孤立性细菌性鼻窦炎导致的眶尖综合征病例。
观察结果
一名63岁女性因孤立性细菌性鼻窦炎出现眶尖综合征，视力迅速下降至无光感。我们将该病例与6例因孤立性细菌性鼻窦炎导致严重视力丧失的类似病例进行了比较。与之前发表的病例不同，我们的患者初诊时视力良好，但尽管接受了适当治疗，仍恶化至无光感。
结论与意义
眶尖综合征可表现为一组颅神经病变，包括因影响眶尖的疾病导致的视神经病变。尽管视力丧失仍为永久性，但及时开始使用广谱抗生素和抗真菌药物以及进行手术干预可防止感染进一步蔓延至颅内结构。
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