Tsuzaki Koji, Murakata Kenji, Kamei Mayu, Kikuya Akihiro, Oka Yuwa, Hamano Toshiaki
Department of Neurology, Kansai Electric Power Hospital, Osaka, Japan.
Division of Clinical Neurology, Kansai Electric Power Medical Research Institute, Osaka, Japan.
Case Rep Neurol Med. 2020 Sep 8;2020:8885166. doi: 10.1155/2020/8885166. eCollection 2020.
Visual impairment can occur because of several mechanisms, including optic nerve disease and occasionally fungal sinusitis. An 87-year-old man presented with the loss of right visual acuity; he was diagnosed with optic neuritis. Steroid pulse therapy was not effective. One month later, he became unconscious because of meningitis, following which treatment with ceftriaxone and acyclovir was initiated. However, his consciousness deteriorated because of a subarachnoid hemorrhage caused by a ruptured aneurysm. Meningitis and vascular invasion caused by fungal rhinosinusitis were suspected, and the sinus mucosa was biopsied. He was pathologically diagnosed with invasive rhinosinusitis. Despite continuous liposomal amphotericin B administration, he died of cerebral infarction, following a right internal carotid artery occlusion. It is important to consider the possibility of as an etiological agent, especially when cerebrovascular events are associated with visual impairment.
视力障碍可由多种机制引起，包括视神经疾病，偶尔也可由真菌性鼻窦炎导致。一名87岁男性出现右眼视力丧失，被诊断为视神经炎。类固醇脉冲疗法无效。一个月后，他因脑膜炎昏迷，随后开始使用头孢曲松和阿昔洛韦治疗。然而，由于动脉瘤破裂导致蛛网膜下腔出血，他的意识恶化。怀疑是真菌性鼻-鼻窦炎引起的脑膜炎和血管侵袭，对鼻窦黏膜进行了活检。他被病理诊断为侵袭性鼻-鼻窦炎。尽管持续给予脂质体两性霉素B治疗，但他因右颈内动脉闭塞导致脑梗死而死亡。尤其是当脑血管事件与视力障碍相关时，考虑[此处原文缺失关键信息，推测为某种病因]作为病因的可能性很重要。
