一名系统性红斑狼疮患者发生诺卡菌性脉络膜脓肿。
Nocardia choroidal abscess in a patient with systemic lupus erythematosus.
作者信息
Yap E Y, Fam H B, Leong K P, Buettner H
机构信息
Department of Ophthalmology, Tan Tock Seng Hospital, Singapore. EngYiatYap/Medical/TTSH@TTSH
出版信息
Aust N Z J Ophthalmol. 1998 Nov;26(4):337-8. doi: 10.1111/j.1442-9071.1998.tb01340.x.
PURPOSE
Nocardia asteroides, a respiratory saprophyte in humans, may cause localized infection of the lungs in debilitated or immunosuppressed individuals. Haematogenous spread to the eye via the choroidal circulation may result in choroidal abscess formation.
METHOD
We report the development of a choroidal abscess in the left eye of a woman treated with steroids and cyclophosphamide for systemic lupus erythematosus. Haematogenous spread of N. asteroides from a localized infection of the lung (empyema) is thought to have been the cause of the choroidal abscess.
RESULTS
Surgical drainage of the empyema combined with intravenously administered antibiotics resulted in resolution of the choroidal abscess and improvement of vision.
CONCLUSIONS
A choroidal abscess, caused by haematogenous spread of N. asteroides, may respond to appropriate systemic antibiotic treatment alone and not require ocular treatment.
目的
星型诺卡菌是人类呼吸道腐生菌，可在体弱或免疫抑制个体中引起肺部局部感染。通过脉络膜循环经血行播散至眼部可导致脉络膜脓肿形成。
方法
我们报告了一名患有系统性红斑狼疮的女性，在接受类固醇和环磷酰胺治疗后左眼发生脉络膜脓肿的情况。推测星型诺卡菌从肺部局部感染（脓胸）经血行播散是脉络膜脓肿的病因。
结果
脓胸手术引流联合静脉使用抗生素后，脉络膜脓肿消退，视力改善。
结论
由星型诺卡菌经血行播散引起的脉络膜脓肿，单独进行适当的全身抗生素治疗可能有效，无需眼部治疗。
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