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題名:AIDS PRESENTING EARLY CYTOMEGALOVIRUS RETINITIS--A CASE REPORT     (14點)
愛滋病以巨細胞病毒性視網膜炎為初始表徵之病例報告
著者:Chieh-Feng Cheng(鄭玠峰) ;Chien-Liang Wu(吳建良) ;Chih-Yu Chen(陳芷郁)
出版地區:台灣
出版城市:台北市
學科:醫學綜合
關鍵字:Cytomegalovirus retinitis ; AIDS ; Gancyclovir ; HAART
刊名:中華民國眼科醫學會雜誌
卷期:47卷1期(2008.3)
頁碼:68-74
語言:英語
摘要: 中文摘要PDF ; 英文摘要PDF

目的:描述一名病患僅以巨細胞性視網膜炎為初 始表徵'進而被發現為愛滋病患之病例報告。 個案:三十歲白人女性,過去無特殊病史,因視 力於數日內急速惡化求診,無其他之身體不適。就診 時視力右眼0.7 ·左眼1. 0. 右眼並出現相對傳入性瞳 孔缺失徵象,眼底檢查雙眼廣泛浸潤性視網膜炎,合 併雙眼視野缺失。血清中抗巨細胞病毒及抗HIV 抗體力價昇高,其他血液學檢查皆正常,無明顯免疫低 下之徵象。病患立即接受抗巨細胞病毒合併抗愛滋病 毒之療程治療三週後,視力右眼0.8 .左眼1. 0. 雙眼 視網膜炎皆明顯消退,視野缺損程度無進一步惡化。 結論:值得注意巨細胞病毒性視網膜炎仍可能為 愛滋病之初始表徵,儘早正確診斷及積極介入治療則 其有令人滿意的效果。
Purpose: To describe a patient had the only initial manifestation of cytomegalovirus (CMV) retinitis, was later diagnosed with Acquired immunodeficiency syndrome (AIDS). From early intervention of anti-CMV medication combined with anti-HIV drugs, the patient had good preservation of final visual outcome on follow-up examinations. Methods: Case repo吋 Case Repo 叫: A 30-year-old white female is an English teacher came to Taiwan for more than 2 years. She had been quite well before, without underIying disease mentioned, except for chronic allergic rhinitis. Blurred vision in progress was found herself since about 3 days ago before she visited our ophthalmologic department. Further examinations were performed, including slit lamp biomicroscopy, best-corrected visual acuity (BCVA) measurement, dilated fundus examination, visual field examination, color fundus photographs, and Fluorecein angiography. Result: Best-corrected visual acuity showed 0.7 on right eye and 1.0 on left eye initially. Relative afferent pupillary defect (RAPD) sign was observed on her right eye, whereas fundus examination showed extensive infiltration of retinitis in both eyes with “brushfire-like" pattern along retinal blood vessels. So that viral retinitis was highly suspected. Blood examination showed high titers of serum CMV antibody and anti-HIV antibody, but absolute neutrophil counts (ANC) and CD4 cell counts were still within normal limits. AIDS complicated with CMV retinitis was diagnosed. Following treatment with Gancyclovir 250 mg eve叩12 hours had been administered intravenously for 2 weeks. Then regimen of Gancyclovir was changed to 250 mg everyday intravenously. At the same time, anti-HIV agents with Highly-active anti-retroviral therapy (HAART, cocktail) were also given. After completing 3 weeks course of treatment, dilated fundus examination showed regressed infiltration of retinitis and good preservation of visual acuity with 0.8 on the right eye and 1.0 on the left eye. She was then discharged from ward under oral Valgancyclovir control. Conclusion: It is wo 吋hy to mention that CMV retinitis can still be the initial manifestation of AIDS. And satisfying outcome of final visual acuity can still be expected by early diagnosis and early intervention with anti-viral treatment.


    

本卷期目次
中華民國眼科醫學會雜誌 47卷1期 (2008.3)
如何診斷正常眼壓青光眼/ 吳秀琛
INTRAVITREAL BEVACIZUMAB FOR CHOROIDAL NEOVASCULARIZATION SECONDARY TO AGE-RELATED MACULAR DEGENERATION--A SHORT-TERM STUDY/ Yu-Lun LoCheng-Kuo ChengChi-Hsien PengTong-Sheng LeeChao-Chien HuTzu-En WuHueu-Chen LinPai-Huei PengChyi-Huey BaiHuey-Shyan Lin
我國與世界各國軍方空勤視力體檢之比較/ 洪啟庭蔡明霖劉峻正黃博宏吳怡昌袁本治孫卓卿
額前肌瓣前移術用於眼瞼下垂之矯正/ 張欣怡蔡顯揚袁漢良
CONJUNCTIVAL MUCOSA-ASSOCIATED LYMPHOID TISSUE (MALT) LYMPHOMA: REPORT OF 6 CASES/ Wan-Ju LeeSung-Huei TsengYing-Ting ChenHon-Chun ChengFu-Chin Huang
IRIS TUMOR AND SECONDARY GLAUCOMA AS INITIAL PRESENTATIONS OF LUNG CARCINOMA: A CASE REPORT/ Ching-Ya HuangKwou-Yeung Wu
ONE-MINUTE SCHIRMER TEST FOR BASAL TEAR SECRETION/ Yung-Ping TsuiWen-Lu ChenChun-Chi ChiangShih-Yuan HuangChiu-Chen HuangYi-Yu Tsai
BILATERAL CATARACTS AFTER PSORALEN AND LONG-WAVE ULTRAVIOLENT RADIATION(PUVA) TREATMENT FOR PSORIASIS/ Chi-Ting HorngKuang-Jen ChienDaih-Iluang KuoFu-An ChenChien-Te LinMing-Ling TsaiPo-Chuen Shieh
GRID PATTERN LASER TREATMENT FOR ATYPICAL CHRONIC RECURRENT CENTRAL SEROUS CHORIORETINOPATHY--CASE REPORT/ Yu-Kai WuCheng-Kuo Cheng
AIDS PRESENTING EARLY CYTOMEGALOVIRUS RETINITIS--A CASE REPORT/ Chieh-Feng ChengChien-Liang WuChih-Yu Chen
ACUTE ORBITAL COMPARTMENT SYNDROME IN A PATIENT WITH SINUSITIS AFTER LACRIMAL IRRIGATION--A CASE REPORT/ Chun-Hsien LiuHsiao-Hsuan TsaiPei-Yu LinChi-Te ChenChieh-Chih TsaiShu-Ching KaoWen-Ming Hsu
IN VIVO CONFOCAL MICROSCOPY OF COMBINED FUCHS' ENDOTHELIAL DYSTROPHY AND PRE-DESCEMET'S MEMBRANE CORNEAL DYSTROPHY--A CASE REPORT/ Chia-Ching HoHuey-Chuan ChengTzong-Shyne Liu
以急性視力受損為全身紅斑性狼瘡的初發表現--病例報告/ 陳俊寰劉美麟
外科手術成功解除因骨纖維結構不良症造成壓迫性視神經病變之病例報告/ 李美侖黃福進史敏秀
 
   
 
   

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