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肉芽肿性多血管炎患者发生真菌性眼内炎。

Fungal endophthalmitis in a case of granulomatosis with polyangitis.

作者信息

AlQahtani Ghadah Mohammed S, AlSayed Alaa Adher D, Gangadharan Shiji, Adhi Mohammad Idrees

机构信息

College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.

Department of Surgery-Division of Ophthalmology, King Abdulaziz Medical City, Riyadh, Saudi Arabia.

出版信息

Saudi J Ophthalmol. 2018 Jul-Sep;32(3):261-265. doi: 10.1016/j.sjopt.2018.01.001. Epub 2018 Feb 2.

Abstract

A 70-year-old immuno-compromised man, due to multiple comorbidities, particularly granulomatosis with polyangitis (GPA) and its related treatment, presented with generalized weakness, odynophagia and loss of taste sensation. After a complete evaluation, a diagnosis of right frontal lobe brain abscess was made. The patient then developed headache and sudden painful loss of vision in the right eye. Clinical examination revealed anterior chamber cells and flare, vitreous haze and cells, and hemorrhagic chorioretinitis with severe vasculitis in the right eye. Culture from the drained pus of the frontal brain abscess came positive for Aspergillus fumigatus. Incidental echocardiogram showed large vegetation in the mitral valve. Pars plana vitrectomy was done and a specimen was sent for culture that came positive for Aspergillus fumigatus. Although all the necessary medical and surgical interventions were timely carried out in the affected right eye, the patient's vision worsened due to retinal damage.

摘要

一名70岁的免疫功能低下男子,因多种合并症,尤其是肉芽肿性多血管炎(GPA)及其相关治疗,出现全身无力、吞咽痛和味觉丧失。经过全面评估,诊断为右额叶脑脓肿。随后,患者出现头痛和右眼突然疼痛性失明。临床检查发现右眼有前房细胞和闪辉、玻璃体混浊和细胞,以及出血性脉络膜视网膜炎伴严重血管炎。额叶脑脓肿引流脓液培养显示烟曲霉阳性。偶然的超声心动图显示二尖瓣有大的赘生物。进行了玻璃体切割术,并送检标本培养,结果烟曲霉阳性。尽管对受影响的右眼及时进行了所有必要的药物和手术干预,但由于视网膜损伤,患者的视力仍恶化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/80c1/6137701/2891d06ce061/gr1.jpg

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