Eyelid Ulcer in an Immunocompromised Patient.

IF 0.6 Q4 OPHTHALMOLOGY

Case Reports in Ophthalmology Pub Date : 2025-06-10 eCollection Date: 2025-01-01 DOI:10.1159/000546662

Kasey M Cooper, Nina S Boal, Karolyn A Wanat, Laila Mossa-Basha, Kartikey Acharya, Natnaelle E Admassu, Gregory J Griepentrog

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引用次数: 0

Abstract

Introduction: Eyelid ulceration can result from malignancy, trauma, infection, or inflammation. Immunosuppressed patients, such as those on methotrexate (MTX) therapy, are at higher risk for opportunistic infections like Purpureocillium lilacinum and Epstein-Barr virus (EBV)-associated mucocutaneous ulcers (EBVMCU). We report a rare case of eyelid ulceration due to concurrent EBVMCU and P. lilacinum infection.

Case presentation: An 82-year-old female with rheumatoid arthritis on chronic MTX therapy presented with a 6-month history of an ulcerated left upper eyelid lesion. Cultures confirmed P. lilacinum, and histopathology revealed EBV-positive atypical B cells. The ulcer resolved after discontinuing MTX and treating with oral voriconazole.

Conclusion: This case highlights the need to consider both fungal and viral infections in immunosuppressed patients with unusual eyelid lesions. Correct diagnosis and appropriate treatment led to a successful outcome in this patient.

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1例免疫功能低下患者眼睑溃疡。

眼睑溃疡可由恶性肿瘤、外伤、感染或炎症引起。免疫抑制患者，如接受甲氨蝶呤（MTX）治疗的患者，发生紫丁香紫球菌和eb病毒（EBV）相关粘膜皮肤溃疡（EBVMCU）等机会性感染的风险更高。我们报告一例罕见的眼睑溃疡，由于并发EBVMCU和紫丁香假单胞菌感染。病例介绍：一个82岁的女性风湿性关节炎慢性甲氨蝶呤治疗提出了6个月的历史溃疡左上眼睑病变。培养证实为淡紫色假单胞菌，组织病理学显示ebv阳性的非典型B细胞。停用甲氨喋呤并口服伏立康唑治疗后溃疡消退。结论：本病例强调了在眼睑异常病变的免疫抑制患者中需要考虑真菌和病毒感染。正确的诊断和适当的治疗使该患者获得了成功的结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Case Reports in Ophthalmology OPHTHALMOLOGY-

CiteScore

0.90

自引率

0.00%

发文量

129

审稿时长

12 weeks

期刊介绍： This peer-reviewed online-only journal publishes original case reports covering the entire spectrum of ophthalmology, including prevention, diagnosis, treatment, toxicities of therapy, supportive care, quality-of-life, and survivorship issues. The submission of negative results is strongly encouraged. The journal will also accept case reports dealing with the use of novel technologies, both in the arena of diagnosis and treatment. Supplementary material is welcomed. The intent of the journal is to provide clinicians and researchers with a tool to disseminate their personal experiences to a wider public as well as to review interesting cases encountered by colleagues all over the world. Universally used terms can be searched across the entire growing collection of case reports, further facilitating the retrieval of specific information. Following the open access principle, the entire contents can be retrieved at no charge, guaranteeing easy access to this valuable source of anecdotal information at all times.