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曲霉性内源性眼内炎作为识别延迟性腰骶部骨髓炎的线索

Aspergillus Endogenous Endophthalmitis as a Clue to Identifying a Delayed Lumbosacral Osteomyelitis.

作者信息

Altinisik Muhammed, Delibay Akgun Yeliz, Erdogan Mustafa, Mutawakkil Azzam Faiz, Gazi Horu

机构信息

Ophthalmology Department, Manisa Celal Bayar University, Manisa, Turkey.

Ophthalmology Department, Medical School, Manisa Celal Bayar University, Manisa, Turkey.

出版信息

Ocul Immunol Inflamm. 2025 Jan;33(1):133-136. doi: 10.1080/09273948.2024.2344704. Epub 2024 Apr 26.

Abstract

PURPOSE

To present a case of aspergillus-induced endogenous endophthalmitis evolving into delayed lumbosacral osteomyelitis, initially misdiagnosed as ankylosing spondylitis (AS) in an immunocompetent patient.

METHOD

Case Report.

RESULTS

A 38-year-old woman, initially treated for pneumonia, experienced sudden loss of vision in her left eye, prompting a thorough examination that revealed a distinct chorioretinal infiltrate. Microbiological analysis of the patient's vitreous samples detected Aspergillus fumigatus, leading to the diagnosis of endogenous endophthalmitis. Treatment involved vitrectomy, intravitreal injections, and intravenous amphotericin B. Two months later, she was referred for lower back pain, misdiagnosed as AS. Lumbosacral biopsy confirmed Aspergillus involvement once more, necessitating antifungal therapy.

CONCLUSION

This case highlights the atypical progression of Aspergillus-induced endogenous endophthalmitis to delayed lumbosacral osteomyelitis in an immunocompetent individual. It highlights the crucial role of a meticulous medical history examination and interdisciplinary collaboration in diagnosing and managing diseases, especially in cases with atypical presentations.

摘要

目的

报告一例曲霉引起的内源性眼内炎演变为延迟性腰骶部骨髓炎的病例,该病例最初在一名免疫功能正常的患者中被误诊为强直性脊柱炎(AS)。

方法

病例报告。

结果

一名38岁女性最初因肺炎接受治疗,随后左眼突然失明,经全面检查发现明显的脉络膜视网膜浸润。对患者玻璃体样本进行微生物分析检测到烟曲霉,从而诊断为内源性眼内炎。治疗包括玻璃体切除术、玻璃体内注射和静脉注射两性霉素B。两个月后,她因下背部疼痛前来就诊,被误诊为AS。腰骶部活检再次证实有曲霉感染,需要进行抗真菌治疗。

结论

该病例突出了曲霉引起的内源性眼内炎在免疫功能正常个体中向延迟性腰骶部骨髓炎的非典型进展。它强调了详细的病史检查和跨学科合作在疾病诊断和管理中的关键作用,特别是在非典型表现的病例中。

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