면역저하 환자에서 진균성 대뇌 동맥류를 동반한 안내염 1예

• 영문명: A Case of Endogenous Aspergillus Endophthalmitis Associated with Mycotic Cerebral Aneurysm
• 발행기관: 대한안과학회
• 저자명: 배신우 채주병,Sinwoo Bae, MD, Ju Byung Chae, MD
• 간행물 정보: 『대한안과학회지』Ophthalmological Society,volume52,number10, 1249~1253쪽, 전체 5쪽
• 주제분류: 의약학 > 기타의약학
• 파일형태: PDF
• 발행일자: 2011.10.15

영문 초록

Purpose: To report a case of a endogenous Aspergillus endophthalmitis associated with mycotic cerebral aneurysmal rupture. Case summary: A 51-year-old woman was referred to our retina clinic for decreased visual acuity in the left eye. The patient had previously undergone a liver transplant for liver cirrhosis and hepatocellular carcinoma. On fundus examination, vitreous opacities with a yellowish-white subretinal abscess were observed. There were no abnormal findings except the positive sign in the laboratory serum Aspergillus antigen test performed on admission. Based on the suspicion of endogenous endophthalmitis, pars plana vitrectomy was performed with intravitreal antibiotics injection to treat fungal and bacterial infections. There was no growth in either the vitreous or anterior chamber culture. After vitrectomy, visual acuity improved and the inflammation subsided. However, by the three-week follow-up, acute-onset left hemiplegia with a right hemisphere cerebral hemorrhage had occurred. Cerebral magnetic resonance angiography showed multiple mycotic aneurysms characterized by a large and fusiform appearance. The patient was treated with neuro-embolization and was stabilized with minimal sequalae. Conclusions: Although the immunocompromised endophthalmitis patient can be treated using proper management, brain lesions such as mycotic aneurysm may exist and should be carefully considered. J Korean Ophthalmol Soc 2011;52(10):1249-1253

키워드

Aneurysm, Aspergillus, Endophthalmitis