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中华实验和临床感染病杂志(电子版) ›› 2021, Vol. 15 ›› Issue (02) : 138 -143. doi: 10.3877/cma.j.issn.1674-1358.2021.02.012

所属专题: 经典病例 文献

病例报告

慢性肝病合并内源性眼内炎五例并文献复习
李炜1, 段英1, 庄立伟1, 邢卉春1,()   
  1. 1. 100015 北京,首都医科大学附属北京地坛医院肝病三科
  • 收稿日期:2020-08-22 出版日期:2021-04-15
  • 通信作者: 邢卉春
  • 基金资助:
    首都卫生发展科研专项(No.首发2020-1-2171); "十三五"艾滋病和病毒性肝炎等重大传染病防治(No. 018ZX10302206-003-006)

Five cases report of chronic liver disease with endogenous endophthalmitis and literature review

Wei Li1, Ying Duan1, Liwei Zhuang1, Huichun Xing1,()   

  1. 1. Central of Liver Diseases Division 3rd, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
  • Received:2020-08-22 Published:2021-04-15
  • Corresponding author: Huichun Xing
引用本文:

李炜, 段英, 庄立伟, 邢卉春. 慢性肝病合并内源性眼内炎五例并文献复习[J]. 中华实验和临床感染病杂志(电子版), 2021, 15(02): 138-143.

Wei Li, Ying Duan, Liwei Zhuang, Huichun Xing. Five cases report of chronic liver disease with endogenous endophthalmitis and literature review[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2021, 15(02): 138-143.

目的

提高临床医师对慢性肝病合并内源性眼内炎的认识及对该疾病的诊疗水平。

方法

回顾分析2009年1月至2020年1月首都医科大学附属北京地坛医院收治的慢性肝病合并内源性眼内炎5例患者的临床特点。

结果

入组5例患者均为慢性肝病基础上出现内源性眼内炎,其中2例为内源性真菌性眼内炎,3例为内源性细菌性眼内炎;5例患者中女性3例、男性2例,年龄49~80岁;均为单眼患病,右眼1例,左眼4例,患眼均失明;其中2例真菌性眼内炎患者的致病菌分别为烟曲霉菌、白色念珠菌;3例细菌性眼内炎分别为肺炎克雷伯菌、咽峡炎链球菌和混合感染(致病菌为肺炎克雷伯菌和金黄色葡萄球菌)患者的致病菌。上述患者均接受全身抗感染治疗,部分患者接受玻璃体腔内注射及玻璃体切割术,患眼均失明。

结论

慢性肝病合并眼内炎较为少见,眼内炎可造成眼组织的毁灭性损害,预后差,早期诊断及治疗极其重要。

Objective

To improve the clinicians’ understanding, diagnostic and therapeutic levels of chronic liver diseases with endogenous endophthalmitis.

Methods

Total of 5 cases of chronic liver diseases with endogenous endophthalmitis admitted to Beijing Ditan Hospital, Capital Medical University from January 2009 to January 2020 were reported. Their diagnosis and treatment were summarized with literature review.

Results

All 5 patients were admitted to our hospital as chronic liver diseases with endogenous endophthalmitis, including 3 females and 2 males, aged from 49 to 80 years old. Two of them were endogenous fungal endophthalmitis, caused by Aspergillus fumigatus and Candida albicans; the other 3 were endogenous bacterial endophthalmitis, caused by Klebsiella pneumoniae, Streptococcus pneumoniae, and mixed infection of Klebsiella pneumoniae and Staphylococcus aureus, respectively. They all received systemic anti-infective therapy, and some of them were even treated with intravitreal injection and vitrectomy. However, the diseased eyes were all blind.

Conclusions

Chronic liver disease with endogenous endophthalmitis was a rare disease with poor prognosis. Endophthalmitis could cause destructive damage to eye tissue. Early diagnosis and treatment are extremely important.

图1 病例1眼部超声图像
图2 病例2腹部增强CT和眼眶CT
图3 病例3眼部超声图像
图4 病例4头颅核磁共振及胸腹部CT
图5 病例5头颅CT
表1 5例慢性肝病合并内源性眼内炎的临床资料
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