获得性免疫缺陷综合征中水痘带状疱疹病毒继发的进行性外层视网膜坏死
Progressive outer retinal necrosis secondary to varicella zoster virus in acquired immune deficiency syndrome.
作者信息
Greven C M, Ford J, Stanton C, Shogreen M, Feldman S, Pegram S, Slusher M M
机构信息
Department of Ophthalmology, Wake Forest University Eye Center, Winston-Salem, North Carolina, USA.
出版信息
Retina. 1995;15(1):14-20. doi: 10.1097/00006982-199515010-00003.
BACKGROUND
A syndrome consisting of rapidly progressive outer retinitis in patients with suppressed immune systems has been described. The etiologic agent appears to be a member of the herpes virus family.
METHODS
A 41-year-old man with acquired immune deficiency syndrome (AIDS) developed bilateral outer retinitis and choroiditis, which progressed despite antiviral treatment. A transscleral eye wall biopsy specimen and whole globe were submitted for microbiologic and histologic study.
RESULTS
Polymerase chain reaction of a transscleral eye wall biopsy specimen and of the enucleated specimen determined the etiologic agent to be varicella zoster virus (VZV). Histologic studies demonstrated intranuclear inclusions consistent with viral particles in choroidal cells.
CONCLUSION
Our study revealed intranuclear inclusions in choroidal cells, a previously undocumented finding in progressive outer retinal necrosis. Polymerase chain reaction was very useful in identifying the causative agent.
背景
已描述了一种在免疫系统受抑制的患者中出现的由快速进展性外层视网膜病变组成的综合征。病原体似乎是疱疹病毒家族的一员。
方法
一名41岁的获得性免疫缺陷综合征（AIDS）患者发生双侧外层视网膜病变和脉络膜炎，尽管进行了抗病毒治疗仍进展。提交了经巩膜眼壁活检标本和整个眼球进行微生物学和组织学研究。
结果
经巩膜眼壁活检标本和眼球摘除标本的聚合酶链反应确定病原体为水痘带状疱疹病毒（VZV）。组织学研究显示脉络膜细胞中存在与病毒颗粒一致的核内包涵体。
结论
我们的研究揭示了脉络膜细胞中的核内包涵体，这是进行性外层视网膜坏死中以前未记录的发现。聚合酶链反应在鉴定病原体方面非常有用。
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