Rocco Joseph M, Benson Maggie K
Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Infect Dis Rep. 2018 Sep 24;10(2):7750. doi: 10.4081/idr.2018.7750. eCollection 2018 Sep 5.
is a common environmental mold most often recognized as an infectious agent in patients with severe immune compromise. We present a case of an immunocompetent patient presenting with endogenous endophthalmitis in the absence of other infectious symptoms. The search for a systemic source revealed an ascending aortic pseudoaneurysm. Surgical resection and pathology revealed angioinvasive aortitis. Recent cardiac surgery has been noted to be a risk factor for angioinvasive aspergillosis. Diagnosis is difficult as symptoms are mild and laboratory studies are often normal. To our knowledge this is the first case of aortitis presenting as endogenous endophthalmitis without systemic signs of inflammation. These patients have a high mortality rate therefore early recognition is essential. It is important to consider angioinvasive infections in patients with prior cardiac surgery presenting with occult embolic phenomena. Only with early diagnosis and prompt treatment can we improve outcomes of this disease process.
是一种常见的环境霉菌，在严重免疫功能低下的患者中最常被视为感染病原体。我们报告一例免疫功能正常的患者，在没有其他感染症状的情况下出现内源性眼内炎。对全身感染源的检查发现升主动脉假性动脉瘤。手术切除及病理检查显示血管侵袭性主动脉炎。近期心脏手术已被认为是血管侵袭性曲霉病的一个危险因素。由于症状轻微且实验室检查通常正常，诊断较为困难。据我们所知，这是首例以无全身炎症体征的内源性眼内炎形式出现的主动脉炎病例。这些患者死亡率很高，因此早期识别至关重要。对于有心脏手术史且出现隐匿性栓塞现象的患者，考虑血管侵袭性感染很重要。只有早期诊断并及时治疗，我们才能改善这一疾病过程的预后。
