真菌感染性视神经炎的临床特征
发布时间：2018-08-18 10:35
【摘要】：目的总结3例确诊的真菌感染性视神经炎患者的临床特点,探讨真菌感染性视神经炎的诊治要点。设计回顾性病例。研究对象3例确诊的真菌感染性视神经炎患者。方法对3例真菌感染性视神经炎患者的症状、体征、影像学检查进行总结,分析归纳真菌感染性视神经炎的临床特点及诊断要点。主要指标临床症状、体征,影像学特点,病理结果。结果 3例真菌感染性视神经炎患者均为中老年男性,单眼或双眼先后发病。合并有系统性疾病。临床表现为急性严重的视力下降,伴头痛、眼痛、眼胀,可伴有眼睑下垂和眼球运动障碍。CT表现为软组织密度影,眼眶侧壁骨质吸收。眼眶磁共振(MRI)异常信号伴不规则强化,边界不清。组织病理见菌丝孢子和真菌团。经手术清除病灶及全身长期抗真菌治疗后症状好转,病情稳定。结论急剧的单侧视力下降伴头痛、眼球胀痛,应考虑到真菌感染的可能。影像学检查辅助诊断,病理活检为诊断金标准。应及时手术清除病灶及全身长期抗真菌治疗。
[Abstract]:Objective to summarize the clinical features of 3 cases of fungal infective optic neuritis and discuss the main points of diagnosis and treatment of fungal infective optic neuritis. Design retrospective cases. Participants three patients with fungal infective optic neuritis were studied. Methods the symptoms, signs and imaging findings of 3 patients with fungal infective optic neuritis were summarized, and the clinical features and diagnostic points of fungal infective optic neuritis were analyzed and summarized. Main outcome measures: clinical symptoms, signs, imaging features and pathological results. Results all the 3 cases of fungal optic neuritis were middle-aged men with monocular or binocular diseases. Complicated with systemic diseases. The clinical manifestations were acute severe visual acuity, headache, eye distension, eyelid droop and ocular movement disorder. Ct showed soft tissue density shadow and bone resorption in the lateral wall of orbit. Abnormal (MRI) signal in orbit with irregular enhancement and unclear boundary. Hyphal spore and mycelium were found in histopathology. The symptoms were improved and stable after long-term anti-fungal therapy. Conclusion the acute unilateral visual acuity with headache and distended eyeball pain should be taken into account the possibility of fungal infection. Imaging examination was used to assist the diagnosis, and pathological biopsy was the diagnostic gold standard. Surgical removal of lesions and long-term anti-fungal therapy should be performed in time.
【作者单位】： 解放军总医院眼科;
【基金】：国家高科技研究发展计划(863计划)基金(2015AA020511)
【分类号】：R774.61
本文编号：2189200
[Abstract]:Objective to summarize the clinical features of 3 cases of fungal infective optic neuritis and discuss the main points of diagnosis and treatment of fungal infective optic neuritis. Design retrospective cases. Participants three patients with fungal infective optic neuritis were studied. Methods the symptoms, signs and imaging findings of 3 patients with fungal infective optic neuritis were summarized, and the clinical features and diagnostic points of fungal infective optic neuritis were analyzed and summarized. Main outcome measures: clinical symptoms, signs, imaging features and pathological results. Results all the 3 cases of fungal optic neuritis were middle-aged men with monocular or binocular diseases. Complicated with systemic diseases. The clinical manifestations were acute severe visual acuity, headache, eye distension, eyelid droop and ocular movement disorder. Ct showed soft tissue density shadow and bone resorption in the lateral wall of orbit. Abnormal (MRI) signal in orbit with irregular enhancement and unclear boundary. Hyphal spore and mycelium were found in histopathology. The symptoms were improved and stable after long-term anti-fungal therapy. Conclusion the acute unilateral visual acuity with headache and distended eyeball pain should be taken into account the possibility of fungal infection. Imaging examination was used to assist the diagnosis, and pathological biopsy was the diagnostic gold standard. Surgical removal of lesions and long-term anti-fungal therapy should be performed in time.
【作者单位】： 解放军总医院眼科;
【基金】：国家高科技研究发展计划(863计划)基金(2015AA020511)
【分类号】：R774.61
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