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艾滋病相关性脉络膜炎。

AIDS-related choroiditis.

作者信息

Canfield Gregory S, Reingold Sarah, Ho Andrea, Thor Ann D, Pecen Paula E, DeSanto Kristen, Chastain Daniel B, Franco-Paredes Carlos, Castillo-Mancilla Jose R, Henao-Martinez Andrés F

机构信息

Division of Infectious Diseases, University of Colorado School of Medicine, Aurora, CO, United States.

Division of Internal Medicine, University of Colorado School of Medicine, Aurora, CO, United States.

出版信息

IDCases. 2020 Aug 8;22:e00931. doi: 10.1016/j.idcr.2020.e00931. eCollection 2020.

Abstract

We describe a case of Cryptococcal choroiditis in a person with advanced HIV/AIDS. A 29-year-old male with AIDS presented with fever, photophobia, and ataxia secondary to cryptococcal and toxoplasma meningoencephalitis. Dilated fundoscopic examination revealed bilateral and multifocal posterior infiltrates consistent with cryptococcal choroiditis. Treatment with parenteral and intravitreal liposomal amphotericin B, oral flucytosine, and oral trimethoprim-sulfamethoxazole led to resolution of his symptoms and improvement in his vision. Our case documents a rare, intraocular opportunistic infection and highlights the importance of ophthalmologic examination in immunocompromised hosts with visual symptoms and invasive fungal infection. We discuss diagnostic and treatment considerations in cryptococcal choroiditis.

摘要

我们描述了一例晚期人类免疫缺陷病毒/获得性免疫缺陷综合征(HIV/AIDS)患者发生的新型隐球菌脉络膜炎。一名患有艾滋病的29岁男性,因新型隐球菌和弓形虫性脑膜脑炎出现发热、畏光和共济失调。散瞳眼底检查发现双侧多发后极部浸润,符合新型隐球菌脉络膜炎表现。经静脉及玻璃体内注射脂质体两性霉素B、口服氟胞嘧啶及口服甲氧苄啶-磺胺甲恶唑治疗后,其症状缓解,视力改善。我们的病例记录了一种罕见的眼内机会性感染,并强调了对有视觉症状和侵袭性真菌感染的免疫功能低下宿主进行眼科检查的重要性。我们讨论了新型隐球菌脉络膜炎的诊断和治疗要点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba74/7452429/9b1ef3d9b4ad/gr1.jpg

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