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[弓形虫性脉络膜视网膜炎:7例患者的临床病程及治疗]

[Toxoplasmosis-chorioretinitis: clinical course and treatment of seven patients].

作者信息

Lebech A M, Lebech M, Børme K K, Mathiesen L R

机构信息

Hvidovre Hospital, infektionsmedicinsk afdeling.

出版信息

Ugeskr Laeger. 1996 Jul 1;158(27):3935-9.

PMID:8701510
Abstract

Toxoplasmosis is a major and preventable cause of severe visual loss and blindness in young people. Ocular toxoplasmosis is the leading cause of posterior uveitis and in most cases it represents a late manifestation of a congenital infection. The clinical picture and anti-Toxoplasma therapy of seven patients referred to the Department of Infectious Diseases, Hvidovre Hospital is described. All patients had clinical ocular toxoplasmosis at initial examination with unilateral focal necrotizing retinitis associated with typical old, pigmented scars. All patients had anti-toxoplasmosis IgG antibodies. After anti-Toxoplasma therapy with sulfadiazine, pyrimethamine and corticosteroid the ocular lesions were healed to atrophic scars and the inflammatory activity disappeared. We conclude that when the clinical picture is compatible with toxoplasmosis, antibodies to Toxoplasma gondii are demonstrated and there is no other diagnosis, anti-Toxoplasma treatment should be considered. It is important to inform pregnant women about prophylactic measures, and to perform a serological screening of newborns, since treatment of congenital toxoplasmosis from birth improves the prognosis.

摘要

弓形虫病是年轻人严重视力丧失和失明的一个主要且可预防的病因。眼部弓形虫病是后葡萄膜炎的主要病因,在大多数情况下,它是先天性感染的晚期表现。本文描述了转诊至维德医院传染病科的7例患者的临床表现及抗弓形虫治疗情况。所有患者初诊时均患有临床眼部弓形虫病,表现为单侧局灶性坏死性视网膜炎,并伴有典型的陈旧性色素沉着瘢痕。所有患者均有抗弓形虫IgG抗体。经磺胺嘧啶、乙胺嘧啶和皮质类固醇进行抗弓形虫治疗后,眼部病变愈合为萎缩性瘢痕,炎症活动消失。我们得出结论,当临床表现与弓形虫病相符、检测到抗刚地弓形虫抗体且无其他诊断时,应考虑进行抗弓形虫治疗。告知孕妇预防措施并对新生儿进行血清学筛查很重要,因为从出生就开始治疗先天性弓形虫病可改善预后。

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