由两种不同病毒病因引起的双侧急性视网膜坏死。
Bilateral acute retinal necrosis caused by two separate viral etiologies.
作者信息
Williams Andrew M, Nguyen Vincent Q, Botsford Benjamin W, Eller Andrew W
机构信息
Retina Service, Department of Ophthalmology, University of Pittsburgh Medical Center, 203 Lothrop Street, Pittsburgh, PA, USA.
出版信息
Am J Ophthalmol Case Rep. 2020 Feb 28;18:100636. doi: 10.1016/j.ajoc.2020.100636. eCollection 2020 Jun.
PURPOSE
To describe an unusual case of bilateral acute retinal necrosis (ARN) that was caused by varicella zoster virus in one eye and Epstein-Barr virus in the fellow eye.
OBSERVATIONS
A 67-year-old immunocompromised man presented with ARN in the left eye following a dermatomal vesicular rash, with an aqueous sample positive for varicella zoster virus. Four months later, the patient presented with panuveitis and serous retinal detachment in the right eye, with vitreous sample positive for Epstein-Barr virus and negative for varicella zoster, herpes simplex, and cytomegalovirus.
CONCLUSIONS AND IMPORTANCE
We report a rare case of bilateral ARN with independent infection of each eye by different viruses; varicella zoster in the left eye and, four months later, Epstein-Barr virus in the right eye. Immunocompromised patients are vulnerable to ARN from any of its inciting viral causes, and intraocular fluid should be obtained for diagnostic confirmation from the second eye in cases of bilateral ARN.
目的
描述一例罕见的双侧急性视网膜坏死（ARN）病例，其中一只眼睛由水痘带状疱疹病毒引起，另一只眼睛由爱泼斯坦-巴尔病毒引起。
观察结果
一名67岁免疫功能低下的男性在出现皮节水疱疹后左眼发生ARN，房水样本水痘带状疱疹病毒检测呈阳性。四个月后，患者右眼出现全葡萄膜炎和浆液性视网膜脱离，玻璃体样本爱泼斯坦-巴尔病毒检测呈阳性，而水痘带状疱疹病毒、单纯疱疹病毒和巨细胞病毒检测呈阴性。
结论与意义
我们报告了一例罕见的双侧ARN病例，每只眼睛由不同病毒独立感染；左眼为水痘带状疱疹病毒，四个月后，右眼为爱泼斯坦-巴尔病毒。免疫功能低下的患者易因任何引发病毒而发生ARN，对于双侧ARN病例，应获取患眼的眼内液进行诊断确认。
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