自愛滋病患者結膜刮取物中培養出巨細胞病毒

Using Conjunctiva Swab to Culture Cytomegalovirus in an Aids Patient

邱士華(Shih-Hwa Chiou) ； 陳永樺(Yeong-Hwa Chen) ； 王永衛(Wing-Wai Wong) ； 翁文松(Wen-Sung Weng) ； 張由美(Yu-Mei Chung) ； 劉榮宏(Jorn-Hon Liu)

《中華民國眼科醫學會雜誌》 37卷3期 (1998/09) Pp. 262-267

https://doi.org/10.30048/ACTASOS.199809.0005

摘要

43歲男性，於85年2月診斷為愛滋病患者，臨床合併感染肺囊胞蟲炎及皮脂漏皮膚炎。自從85年10月份兩眼感到不適、異物感且分泌物增加等症狀，眼科檢查時發現兩眼結膜血管充血，右眼眼底週邊視網膜有一顆粒狀黃白相間的壞死病灶。眼底螢光血管攝影發現位於右眼病灶視網膜血管有不正常螢光染劑滲漏現象。經結膜分泌物刮取(conjunctival swab)，其檢體於胚胎纖維母細胞(embryonic fibroblasts)培養基中，結果呈現典型巨細胞病毒(cytomegalovitus)之細胞病變反應(cytopathic effect)及細胞內包涵體(inclusion body)之現象。這些有病變反應之細胞經免疫螢光染色檢定，對巨細胞病毒單株抗體染色呈陽性反應。本篇病例報告自愛滋病患者結膜刮取物中培養出活的巨細胞病毒，以提醒眼科醫師，日後在檢查愛滋病患者眼部時，應當使用隔離手套，以避免由眼分泌物造成感染之可能。

並列摘要

A 43-year-old heterosexual man, who had the history of AIDS for 8 months, was afflicted with pneumomia and seborrheic dermatitis. The patient complained of foreign body sensation and discharge of both eyes for 2 months. The slit lamp showed the conjunctival congestion in both eyes. The eye fundus examination revealed a yellowish and white granular foci at the peripheral retinae of right eye. The fluorescein angiography revealed numerous hyperfluo-rescent spots and dye leakages from retinal vessel in the granular lesion of the right eye. Conjunctiva swab was done by whisking cotton swab on patients conjunctiva of both eyes. A characteristic cytopathic effect of CMV presented in a culture of human embryonic fibroblasts with conjunctival swab. Meanwhile, the infected fibroblasts were stained by CMV monoclonal antibody for detection of CMV early protein antigen. Herein we reported this case and suggested that ophthalmologists should be more attention and use gloves during the routine eye examination for AIDS patients.

並列關鍵字

conjunctival swab ； cytomegalovirus ； embryonic fibroblasts ； cytopathic effect ； inclusion body