Drishti Eye Institute, Drishti Eye Institute, Dehradun, India.
Dr. Ahuja's Pathology and Imaging Centre, Dr. Ahuja's Pathology and Imaging Centre, Dehradun, India.
Ocul Immunol Inflamm. 2023 Jan;31(1):236-241. doi: 10.1080/09273948.2021.2018713. Epub 2022 Jan 20.
To report nontubercular choroiditis, caused by isolated using MALDI-TOF MS, following laparoscopic hysterectomy in an immunocompetent patient.
A 42-year-old female presented with gradual, painless diminution of vision in the right eye for six weeks. She had undergone laparoscopic hysterectomy two months back. BCVA was 2/60 OD. Clinical presentation and imaging all pointed to a diagnosis of serpiginous-like choroiditis. Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS) had led to isolation of . Patient was treated with systemic antibiotics. At 3 months follow up, BCVA improved to 6/60; fundus showed healed choroiditis and chorioretinal thinning.
Atypical mycobacterial infections associated with laparoscopic surgeries can rarely lead to debilitating systemic bacteremia resulting in profound visual impairment. The importance of timely diagnosis using specific and sophisticated methods such as MALDI-TOF MS as well as maintaining aseptic precautions perioperatively during major surgeries cannot be overemphasized.
报道 1 例免疫功能正常患者腹腔镜子宫切除术后,由 MALDI-TOF MS 分离出的非结核性脉络膜炎。
1 名 42 岁女性,诉 6 周前右眼逐渐出现无痛性视力下降。2 个月前行腹腔镜子宫切除术。右眼最佳矫正视力(BCVA)为 2/60。临床表现和影像学检查均提示匐行性脉络膜炎。基质辅助激光解吸电离飞行时间质谱(MALDI-TOF MS)检测到 的分离。患者接受了全身抗生素治疗。3 个月时随访,BCVA 提高至 6/60;眼底显示脉络膜炎愈合,脉络膜视网膜变薄。
与腹腔镜手术相关的非典型分枝杆菌感染可导致严重的全身菌血症,导致严重的视力损害。重要的是,要及时使用 MALDI-TOF MS 等特异性和复杂的方法进行诊断,并在重大手术期间始终保持无菌预防措施。