手术后眼内炎并继发脑膜炎。关于一个病例

S Hernández Santamaría, N García Figuera, M Maldonado MacCrohon, L Jordano Luna, A Laiseca García, M T Álvarez Barrio
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引用次数: 0

摘要

一名 61 岁的男子在接受玻璃体旁切除术后,因奇异变形杆菌引发了超急性眼内炎。首次检查(术后 24 小时)时,视力(VA)为手动量,生物显微镜检查显示角膜水肿、Tyndall ++++ 和纤维蛋白膜,并伴有玻璃体炎,无法看到视网膜细节。患者接受了玻璃体内注射治疗。尽管进行了治疗,但患者的症状还是恶化了,开始出现全身状况不佳、发热和白细胞增多等症状,需要住院并接受静脉注射治疗,因为他被诊断为手术后眼内炎引起的继发性脑膜炎。患者需要对患眼进行去核手术,但未植入人工晶体。尽管手术后细菌性眼内炎通常是局限于眼部的感染,但这一临床病例表明感染有可能扩散到身体其他部位,从而可能危及患者的生命。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Post-surgical endophthalmitis with secondary meningitis. About a case.

A 61-year-old man presented hyperacute endophthalmitis due to Proteus mirabilis after a pars plana vitrectomy. In the first examination (24 h after surgery), visual acuity (VA) was of hand movement, biomicroscopy showed edematous cornea, Tyndall ++++ and fibrin membrane, with vitritis and impossibility of visualizing retina details. Treatment with intravitreal injections was performed. Despite the treatment, the patient's symptoms worsened, and he began with poor general condition, fever, and leukocytosis, requiring hospitalization and intravenous treatment because of a diagnosis of secondary meningitis due to post-surgical endophthalmitis. The patient required enucleation of the affected eye without prosthesis placement. Even though post-surgical bacterial endophthalmitis is usually an infection confined to the eye, this clinical case demonstrates the possibility of the infection spreading to the rest of the body, potentially endangering the patient's life.

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