一名年轻成年静脉吸毒者眼部弓蛔虫病表现为眼内炎
Ocular Toxocariasis Presenting as Endophthalmitis in a Young Adult Intravenous Drug User.
作者信息
Singh Pali P, Robbins Cason B, Feng Henry L, Borkar Durga S, Fekrat Sharon
机构信息
Duke University School of Medicine, Durham, NC, USA.
Duke Eye Center, Duke University, Durham, NC, USA.
出版信息
J Vitreoretin Dis. 2020 Sep 17;5(2):170-172. doi: 10.1177/2474126420946587. eCollection 2021 Mar-Apr.
PURPOSE
This report describes the diagnosis of ocular toxocariasis presenting as endophthalmitis in an adult intravenous drug user.
METHODS
A case is reported.
RESULTS
Fundus imaging showed numerous white opacities obscuring the macula. serology was reactive with an enzyme immunoassay titer of 1:2 (positive ≥ 1:32). Findings from bacterial and fungal cultures were negative, and vitrectomy cytology revealed no organisms. Postoperatively, serial optical coherence tomography imaging demonstrated a slight decrease in size of an intraretinal hyperreflective lesion in the macula.
CONCLUSIONS
Owing to a variety of presentations, ocular toxocariasis can be challenging to diagnose. In a patient with a history of intravenous drug use where fungal and bacterial organisms are more common causes of endophthalmitis, it is important to have a wide differential of causative organisms, particularly in the context of negative culture results and a worsening clinical examination.
目的
本报告描述了一名成年静脉吸毒者以眼内炎形式出现的眼部弓蛔虫病的诊断情况。
方法
报告一例病例。
结果
眼底成像显示大量白色混浊物遮盖黄斑。血清学检查通过酶免疫测定法呈阳性反应，滴度为1:2（阳性≥1:32）。细菌和真菌培养结果均为阴性，玻璃体切割术细胞学检查未发现病原体。术后，连续光学相干断层扫描成像显示黄斑区视网膜内高反射性病变大小略有减小。
结论
由于眼部弓蛔虫病有多种表现形式，其诊断可能具有挑战性。对于有静脉吸毒史且真菌和细菌病原体是眼内炎更常见病因的患者，重要的是对病原体进行广泛鉴别，尤其是在培养结果为阴性且临床检查情况恶化的情况下。
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