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从误诊到治疗:一例眼部炎症性疾病的病例报告

From Misdiagnosis to Management: A Case Report of Ocular Inflammatory Disease.

作者信息

Francisco Catarina M, Santos Miguel, Mano Sofia, Leal Inês, Coelho Joana

机构信息

Pediatrics, Hospital Sousa Martins, Guarda, PRT.

Ophthalmology, Hospital de Santa Maria, Unidade Local de Saúde (ULS) Santa Maria, Lisbon, PRT.

出版信息

Cureus. 2024 Jul 27;16(7):e65491. doi: 10.7759/cureus.65491. eCollection 2024 Jul.

Abstract

Ocular inflammatory diseases encompass a spectrum of conditions characterized by inflammation within the eye, presenting diagnostic challenges and necessitating tailored management. Ocular toxoplasmosis (OT) poses a challenge in diagnosis and management due to its diverse clinical presentations. We present a case report of a 17-year-old female adolescent who presented with blurred vision and ocular pain, initially misdiagnosed as optic neuritis. Despite receiving methylprednisolone, her symptoms persisted, prompting further evaluation. Ophthalmoscopic examination revealed a whitish focus of chorioretinitis adjacent to an old scar, indicative of OT. Optical coherence tomography confirmed retinochoroiditis, and sulfamethoxazole-trimethoprim was added, resulting in improvement. This case underscores the importance of considering OT in the differential diagnosis of ocular manifestations, especially in individuals with relevant family history, despite atypical presentations. Timely recognition, accurate diagnosis, and prompt initiation of appropriate therapy are crucial to preserve patients' visual function.

摘要

眼部炎性疾病包括一系列以眼内炎症为特征的病症,带来了诊断挑战,需要进行针对性治疗。眼部弓形虫病(OT)因其多样的临床表现,在诊断和治疗方面构成挑战。我们报告一例17岁女性青少年病例,该患者出现视力模糊和眼痛,最初被误诊为视神经炎。尽管接受了甲泼尼龙治疗,其症状仍持续存在,促使进一步评估。眼底镜检查发现一处白色脉络膜视网膜炎病灶紧邻陈旧瘢痕,提示为OT。光学相干断层扫描证实为视网膜脉络膜炎,加用磺胺甲恶唑-甲氧苄啶后病情改善。该病例强调了在眼部表现的鉴别诊断中考虑OT的重要性,尤其是在有相关家族史的个体中,尽管表现不典型。及时识别、准确诊断并迅速开始适当治疗对于保护患者的视觉功能至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03d1/11345657/5dee6baf87d1/cureus-0016-00000065491-i01.jpg

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