Murawski Shannon, Farrell Michael, Cordeiro-Rudnisky Fernanda, Blinkhorn Richard
Internal Medicine, Albany Medical College, Albany, New York, USA.
Pathology, Albany Medical College, Albany, New York, USA.
BMJ Case Rep. 2019 Jul 18;12(7):e228681. doi: 10.1136/bcr-2018-228681.
A 43-year-old man with history of non-Hodgkins' lymphoma presented with unilateral eye swelling, pain and vision deficits which had been progressive over 2 months. Symptoms followed a presumed bacterial pneumonia 4 months prior. Imaging demonstrated retro-orbital soft tissue swelling with bony erosion concerning for a mass; surgical decompression was performed with histology confirming disseminated Symptoms responded rapidly to antifungal therapy with amphotericin followed by itraconazole. Orbital dissemination of blastomycosis is extremely rare; accurate diagnosis requires tissue biopsy to facilitate timely targeted therapy and minimise morbidity.
一名43岁有非霍奇金淋巴瘤病史的男性，出现单侧眼部肿胀、疼痛和视力减退，症状在2个月内逐渐加重。症状出现在4个月前疑似细菌性肺炎之后。影像学检查显示眶后软组织肿胀并伴有骨质侵蚀，怀疑有肿块；进行了手术减压，组织学检查证实为播散性感染。症状在用两性霉素随后用伊曲康唑进行抗真菌治疗后迅速缓解。芽生菌病眼眶播散极为罕见；准确诊断需要组织活检，以便及时进行靶向治疗并将发病率降至最低。
