- 期刊
- OpenAccess
OCULAR SYPHILIS DIAGNOSED BY IMMUNOHISTOCHEMISTRY: A CASE REPORT
以免疫組織化學染色法診斷之眼部梅毒：案例報告
摘要
目的：報告一例以免疫組織化學染色法診斷的眼梅毒案例。方法：病例報告。結果：一名25歲男性至門診主訴右眼視力模糊三天。病人右眼可見嚴重的全葡萄膜炎併週邊視網膜白色病灶。血清學檢查呈現陽性反應的快速血漿反應素凝絮測試及梅毒螺旋體血球凝集試驗，病人又曾有未完全治療的奈瑟式淋病雙球菌的泌尿道感染。於是我們做了診斷性的玻璃體抽吸並將檢體進行免疫組織化學染色法，革蘭氏染色法，及細菌培養。免疫組織化學染色發現梅毒螺旋體的存在，於是證實了眼部梅毒感染。病人也接受西方墨點染色法檢驗人類免疫不全病毒，其結果呈現陽性反應。經過兩週治療神經性梅毒的盤尼西林G針劑治療，兩個月後病人右眼發炎情況及視力皆有改善。結論：眼梅毒可能以各種形式的葡萄膜炎來表現。梅毒螺旋體的免疫組織化學染色法可以確認梅毒螺旋體的存在並幫助我們診斷眼梅毒。
關鍵字
無資料並列摘要
Purpose: To present a case of ocular syphilis diagnosed by immunohistochemical (IHC) staining. Method: A case report. Result: A 25 year-old man with a 3-day history of blurred vision in the right eye visited our clinic. Severe panuveitis with a whitish lesion over the peripheral retina was observed in his right eye. Serological tests were positive for rapid plasma reagin (RPR) and T. pallidum hemagglutination assay (TPHA). The patient also had a history of incompletely treated Neisseria gonorrhoeaeinduced urethritis. Diagnostic vitreous tapping of the right eye was performed, followed by IHC staining with T. pallidum antibodies, Gram staining, and bacterial culture. Ocular syphilis was confirmed by positive IHC staining for spirochetes. A Western blot test for human immunodeficiency virus (HIV) also yielded positive. The patient underwent a 2-week course of intravenous aqueous penicillin G treatment for neurosyphilis. His right eye ocular inflammation and visual acuity improved within 2 months. Conclusion: Ocular syphilis may present as any type of uveitis, including panuveitis. IHC staining with T. pallidum antibodies can help confirm the presence of spirochetes and establish a diagnosis in such cases.