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隐匿性眼外伤后伪装成全葡萄膜炎的眼内炎

Endophthalmitis Masquerading as Panuveitis After an Imperceptible Ocular Trauma.

作者信息

Sanchez Juan Martin, Almeida Diego, Jaouni Tareq, Amer Radgonde

机构信息

Hadassah University Hospital, Ophthalmology Clinic, Jerusalem, Israel

出版信息

Turk J Ophthalmol. 2019 Feb 28;49(1):44-46. doi: 10.4274/tjo.galenos.2018.44520.

Abstract

Endophthalmitis after a penetrating trauma occurs in 3% to 30% of cases. Prompt recognition and treatment are paramount to avoid irreversible visual loss. We present a case of severe panuveitis following ocular trauma with a tree branch that did not cause any evident ocular wound and discuss the difficulties in achieving a diagnosis that can allow proper treatment. A healthy 21-year-old man presented with acute anterior uveitis. He was managed elsewhere with oral acyclovir and topical steroids for presumed herpetic uveitis. He subsequently developed severe panuveitis with profound decrease in vision. Diagnostic vitrectomy was performed and vitreous samples were positive for . Systemic and intravitreal antibiotic therapy was initiated and after 5 days, the patient recovered with a remarkable improvement in visual acuity to 6/12. Post-traumatic endophthalmitis can result from an imperceptible trauma with no obvious compromise of the globe.

摘要

穿透性眼外伤后眼内炎的发生率为3%至30%。迅速识别和治疗对于避免不可逆转的视力丧失至关重要。我们报告一例眼部被树枝划伤后发生严重全葡萄膜炎的病例,该损伤未造成任何明显的眼部伤口,并讨论了在做出能够进行恰当治疗的诊断时所遇到的困难。一名21岁健康男性因急性前葡萄膜炎就诊。他在其他地方接受治疗,因疑似疱疹性葡萄膜炎接受口服阿昔洛韦和局部使用类固醇治疗。随后,他发展为严重全葡萄膜炎,视力急剧下降。进行了诊断性玻璃体切割术,玻璃体样本检测呈阳性。开始进行全身和玻璃体内抗生素治疗,5天后,患者视力显著提高至6/12,康复出院。创伤后眼内炎可能由难以察觉的外伤引起,眼球无明显损伤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06ce/6416482/fada9cd16096/TJO-49-44-g1.jpg

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