頁籤選單縮合
題名 | Cryptococcal Meningoencephalitis: An Atypical Presentation with Diplopia=隱孢球菌腦膜炎:以複視表現之病例報告 |
---|---|
作者姓名(中文) | 莊雅媜; 張集武; 劉智誠; 彭美玲; | 書刊名 | 中華民國眼科醫學會雜誌 |
卷期 | 49:4 2010.12[民99.12] |
頁次 | 頁629-633 |
分類號 | 415.9313 |
關鍵詞 | 隱孢球菌腦膜炎; 複視; 顱內減壓手術; 抗黴菌藥物; Cryptococcus neoformans; Meningoencephalitis; Diplopia; Immunocompetent; |
語文 | 英文(English) |
中文摘要 | 目的:報告以複視為初始表現之隱孢球菌腦膜炎病例及其面變。方法:病例報告。結果:一位三十歲健康男性因持續雙眼複視併頭痛及眼周疼痛來診。理學檢查見雙側外直肌功能衰退、左眼眼球突出、及右側視視乳突充血。視力、視野、及影像檢查均正常。在疑似偽腫瘤的診斷下以類固醇靜脈注射治療後,症狀先改善後隨即復發加劇,經腦脊髓液檢查證實為隱孢球菌腦膜炎。予持續抗黴菌藥物及顱內減壓手術治療後頂後良好。結論:隱孢球菌腦膜炎可能發生於免疫健全宿主,多樣的初始表現與看似正常的影像檢查均增加了診斷的困難度。早期診斷與積極的降腦壓治療可提供較好的癒後。 |
英文摘要 | Purpose: To report a case of cryptococcal meningoencephalitis primarily presented with diplopia. Method: A case report. Result: A 30-year-old healthy male computer designer had binocular diplopia followed by headache for 1 week. Left eye proptosis, bilateral lateral rectus muscle weakness and mild peripapillary congestion (OD) were noted. Orbital pseudotumor was impressed initially and symptoms were improved after pulse therapy. However, episodic severe headache and hallucination occurred one week later. Further, the lumbar puncture and CSF culture revealed Cryptococcus neoformans infection. Persistent spiking fever, increased intracranial pressure and septic shock developed later. In addition to anti-fungal therapy, he received craniotomy to remove the subdural empyema. Systemic conditions were soon stabilized after the operation. The visual condition recovered well with excellent visual acuity (1.0/1.0) and normal eye movement without diplopia. Conclusion: Cryptococcal meningoencephalitis could present with diplopia especially in young adults who are not immunocompromised. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。