囊球菌腦膜炎引起之眼部病變－病例報告

Occular Complications of Cryptococcal Meningitis-Case Report

李家福(Chia-Fwu Lee) ； 丁民峰(Ming-Fong Ting) ； 林嘉理(Chia-Lee Lin)

《中華民國眼科醫學會會刊》 30卷2期 (1991/12) Pp. 162-166

https://doi.org/10.30048/ACTASOS.199112.0070

摘要

囊球菌(Cryptococcus)是一種全身性感染之黴菌(上標 (10))。當其感染於中樞神經時，才會有症狀出現。在腦膜發炎時，視神經網膜也同時產生變化，造成畏光、複視、斜視、眼球顫震，視神經盤浮腫，網膜炎，眼底血管病變及視神經萎縮等(上標 (1-7))，其進入眼球之途程，有（一）直接由視神經纖維或腦膜腔，（二）向血液循環進入(上標 (8,9))。本報告提出兩病例，將其眼底變化，眼底螢光攝影和視神經變化等之追蹤結果予以報告。

並列摘要

Cryptococosis is a world-wide infectious disease caused by Cryptococcus Neoformans that becomes perceptible to the patient only after central nervous system involved. Headache is the most common complaint and other symptoms including mental change, fever, nceck pain, nausea, vomiting and weakness are noted.
The ocular complications are photophobia, diplopia, ptosis, nystagmus, ophthalmoplegia, primary optic atrophy, papilledema and neuroretinitis. The ocular infection is rare, the most frequently eye involvement is either the result of direct extension to the optic nerve via the subarachnoidal space, or disseminated with blood stream. Untreated cryptococcal meningitis is a fatal disease. After the introduction of amphotericin-B, 50% of patient are cured. However, some patient are living with permanent neurologic or ocular complications.
We present 2 cases of cryptococcal meningtis with ocular complications. Loss of vision of patients are noted even treated with antifungal drugs.

並列關鍵字

Cryptococcus Neoformans ； Meningitis ； optic atrophy Cryptococosis