论文部分内容阅读
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。
Objective To summarize the clinical features of 3 patients with fungal infective optic neuritis confirmed and to explore the main points of diagnosis and treatment of fungal infective optic neuritis. Design retrospective case. Study object 3 cases of fungal infection in patients with optic neuritis. Methods The symptoms, signs and imaging findings of 3 cases of fungal infective optic neuritis were summarized. The clinical features and diagnosis points of fungal infective optic neuritis were summarized. The main indicators of clinical symptoms, signs, imaging features, pathological findings. Results 3 cases of fungal infection of optic neuritis patients are middle-aged men, one or both eyes have morbidity. Combined with systemic diseases. Clinical manifestations of acute severe vision loss, with headache, eye pain, eye swelling, may be associated with ptosis and eye movement disorders. CT showed soft tissue density, orbital side bone absorption. Orbital magnetic resonance (MRI) abnormal signal with irregular enhancement, the border is unclear. Histopathology mycelial spores and fungal groups. Surgical removal of lesions and systemic anti-fungal treatment of symptoms improved, stable condition. Conclusions Acute unilateral visual loss with headache and eyeball pain should be considered for fungal infection. Imaging diagnosis of auxiliary diagnosis, biopsy for the diagnosis of gold standard. Timely surgical removal of lesions and systemic long-term anti-fungal treatment.