Kasey M Cooper, Nina S Boal, Karolyn A Wanat, Laila Mossa-Basha, Kartikey Acharya, Natnaelle E Admassu, Gregory J Griepentrog
{"title":"1例免疫功能低下患者眼睑溃疡。","authors":"Kasey M Cooper, Nina S Boal, Karolyn A Wanat, Laila Mossa-Basha, Kartikey Acharya, Natnaelle E Admassu, Gregory J Griepentrog","doi":"10.1159/000546662","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>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 <i>Purpureocillium lilacinum</i> and Epstein-Barr virus (EBV)-associated mucocutaneous ulcers (EBVMCU). We report a rare case of eyelid ulceration due to concurrent EBVMCU and <i>P. lilacinum</i> infection.</p><p><strong>Case presentation: </strong>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 <i>P. lilacinum</i>, and histopathology revealed EBV-positive atypical B cells. The ulcer resolved after discontinuing MTX and treating with oral voriconazole.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":"16 1","pages":"510-514"},"PeriodicalIF":0.6000,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263146/pdf/","citationCount":"0","resultStr":"{\"title\":\"Eyelid Ulcer in an Immunocompromised Patient.\",\"authors\":\"Kasey M Cooper, Nina S Boal, Karolyn A Wanat, Laila Mossa-Basha, Kartikey Acharya, Natnaelle E Admassu, Gregory J Griepentrog\",\"doi\":\"10.1159/000546662\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>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 <i>Purpureocillium lilacinum</i> and Epstein-Barr virus (EBV)-associated mucocutaneous ulcers (EBVMCU). We report a rare case of eyelid ulceration due to concurrent EBVMCU and <i>P. lilacinum</i> infection.</p><p><strong>Case presentation: </strong>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 <i>P. lilacinum</i>, and histopathology revealed EBV-positive atypical B cells. The ulcer resolved after discontinuing MTX and treating with oral voriconazole.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":9635,\"journal\":{\"name\":\"Case Reports in Ophthalmology\",\"volume\":\"16 1\",\"pages\":\"510-514\"},\"PeriodicalIF\":0.6000,\"publicationDate\":\"2025-06-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263146/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Case Reports in Ophthalmology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1159/000546662\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Case Reports in Ophthalmology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1159/000546662","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
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.
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.
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