急性後天性眼部弓漿蟲病－病例報告

Acute Acquired Ocular Toxoplasmosis-A Case Report

潘世強(Shih-Chiang Pan) ； 梁巧盈(Chau-Ying Liang) ； 蔡顯揚(Hin-Yeung Tsai)

《中華民國眼科醫學會雜誌》 41卷2期 (2002/06) Pp. 194-199

https://doi.org/10.30048/ACTASOS.200206.0017

摘要

目的：本文報告一急性後天性眼部弓漿蟲病之病例。
方法：病例報告
結果：眼部弓漿蟲病是由Toxoplasma gondii原蟲所引起。常見的病灶為局部壞死性視網膜炎、玻璃體炎及後葡萄膜炎。本文報告一位三十九歲健康男性，主訴左眼視力突然模糊，視野正中央有一圓盤狀黑影，症狀持續已有一週。眼底檢查發現左眼黃斑部有一灰白色棉絮狀邊緣的視網膜病灶，合併輕微玻璃體炎。血管螢光攝影檢查發現左眼在螢光晚期時，黃斑部病灶呈現高螢光反應並且有螢光染劑滲漏現象。血清學檢查發現弓漿蟲IgM抗體及IgG抗體皆明顯的升高。本病例診斷為急性後天眼部弓漿蟲病。所採用的治療藥物包括口服Baktar, Clindamycin, Prednisolone，及局部1% Prednisolone acetate眼藥水；治療期間持續五週。治療後四週，黃斑部病灶開始形成穩定纖維化疤痕。追蹤至今兩年，並無復發現象。
結論：藉由高度懷疑、精確的臨床觀察、及適當的實驗室檢驗，可以早期診斷此種疾病。適當的藥物治療可以迅速有效的控制疾病並縮短病程。

並列摘要

Toxoplasma gondii is an obligate intracellular protozoan that commonly causes a focal necrotizing retinitis and posterior uveitis. We present a 39-year-old previously healthy male patient who suffered from suddenly blurred vision of the left eye with dot-shape visual field defect noted for 1 week. Fundus examination showed fluffy whitish macular lesion with mild overlying vitritis of the left eye. The FAG showed hyperfluorescence and leakage of macular lesion in the late phase. The serology study revealed clinically significant toxoplasma IgM and IgG titer by IFA and ELISA. Acute acquired ocular toxoplasmosis was diagnosed. The patient received medication including oral baktar, clindamycin, and prednisolone, and topical 1% prednisolone acetate eye drops for 5 week. Macular scarring and silent vitreous were noted after the fourth week of treatment. In the 2-year follow-up period, the macular lesion showed stable fibrotic scar, and no recurrent episode was noted.

並列關鍵字

Ocular toxoplasmosis ； Acquired ； Retinitis