Acute Cortical Blindness: A Rare Initial Presentation of Infective Endocarditis

急性眼盲：感染性心內膜炎罕見的早期臨床表現

劉德銘(Te-Ming Liu) ； 嚴元隆(Yuan-Lung Yen) ； 湯宏仁(Hung-Jen Tang) ； 莊銀清(Yin-Ching Chuang)

《中華民國急救加護醫學會雜誌》 14卷1期 (2003/03) Pp. 35-40

https://doi.org/10.30018/JECCM.200303.0007

摘要

感染性心入膜炎的臨床表現可能來自系統性的感染、血管內的病灶、免疫的反應和併發症等。它可能在急診醫師面前呈現各種不同的面貌。本文描述一位38歲男性罹患感染性心內膜炎在疾病初期表現發燒、頭痛、腹痛及急性眼盲。眼盲次發於兩側腦枕葉血栓性梗塞，為感染性心內膜炎的併發症。它是少見的神經學合併症，且早期出現可能與金黃色葡萄球菌感染有關。及早診斷和治療為佭低死亡率和減少併發症產生之重要因素。本病例顯示出現急性皮質性眼盲，特別是有發燒及心雜音時，需將感染性心內膜炎列鑑別診斷。

關鍵字

感染性心內膜炎 ； 血栓性腦梗塞 ； 皮質性眼盲

並列摘要

Clinical features of infective endocarditis (IE) may come from systemic infections, intravascular lesions, immunological responses, and its complications. It has varied manifestations which present to emergency department physicians. This report describes a case of IE in a 38-year-old man who had fever, headache, abdomen pain, and notably, acute blindness at the beginning of the illness. The blindness was secondary to embolic infarction of both occipital lobes developing as a sequela of IE. This is an unusual neurologic complication of IE, tends to occur in the early stage of the illness, and may be related to Staphylococcus aureus infection. To reduce mortality and complications, early diagnosis and treatment are critical. This case indicates that IE should be considered in cases of acute cortical blindness, especially those with fever and heart murmur.

並列關鍵字

Acute Cortical Blindness: A Rare Initial Presentation of Infective Endocarditis