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HHV-6B 和 HHV-7 相关性脉络膜炎继发于急性髓系白血病:病例报告。

HHV-6B- and HHV-7-associated choroiditis secondary to acute myelogenous leukemia: a case report.

机构信息

Department of Ophthalmology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.

Department of Research and Development, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.

出版信息

J Int Med Res. 2023 Oct;51(10):3000605231204479. doi: 10.1177/03000605231204479.

Abstract

We report a case of human herpes virus 6 (HHV-6)- and human herpes virus 7 (HHV-7)-associated choroiditis in an immunocompromised woman. A 42-year-old Chinese woman with a history of acute myelogenous leukemia presented with blurred vision and black floaters in her right eye. Anterior segment examination findings were normal. Ophthalmoscopic examination revealed a subretinal lesion in the superonasal peripapillary region with several punctate hemorrhages. Optical coherence tomography showed a crater-like choroidal protuberance, associated with retinal pigment epithelium rupture and full-thickness retinal edema in the involved area. Indocyanine green angiography demonstrated a broad hypofluorescent lesion in the choroid. The patient was diagnosed with choroiditis. Subsequently, metagenomic next-generation sequencing revealed HHV-6B and HHV-7 DNA in the aqueous humor. Therefore, antiviral therapy was initiated. The patient experienced resolution of all symptoms and signs after treatment with intravenous foscarnet and oral acyclovir. The findings in this case indicate that HHV-6 and HHV-7 can cause ocular infection, particularly in immunocompromised patients.

摘要

我们报告了一例免疫功能低下女性的人类疱疹病毒 6(HHV-6)和人类疱疹病毒 7(HHV-7)相关性脉络膜炎。一名 42 岁的中国女性,有急性髓系白血病病史,出现右眼视力模糊和黑色漂浮物。眼前节检查未见异常。眼底检查发现视盘上方鼻侧有一视网膜下病变,伴有数个点状出血。光学相干断层扫描显示脉络膜隆突呈火山口样,伴有受累区域的视网膜色素上皮破裂和全层视网膜水肿。吲哚青绿血管造影显示脉络膜有一广泛低荧光病变。患者被诊断为脉络膜炎。随后,宏基因组下一代测序显示房水中存在 HHV-6B 和 HHV-7 DNA。因此,开始抗病毒治疗。该患者经更昔洛韦静脉注射和阿昔洛韦口服治疗后,所有症状和体征均消失。该病例的发现表明,HHV-6 和 HHV-7 可引起眼部感染,尤其是在免疫功能低下的患者中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de98/10594963/d0a36bcac89c/10.1177_03000605231204479-fig1.jpg

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