机构:[1]Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China研究所眼科研究所首都医科大学附属北京同仁医院首都医科大学附属同仁医院[2]Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Sciences Key Laboratory首都医科大学附属北京同仁医院首都医科大学附属同仁医院[3]Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing, China临床科室神经内科首都医科大学附属北京同仁医院首都医科大学附属同仁医院[3]Department of Ophthalmology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Ruprecht- Karls-University Heidelberg, Mannheim, Germany
To describe a patient who initially presented with features of Vogt-Koyanagi-Harada disease and who eventually demonstrated symptoms of mycotic meningitis.An 18-year-old immunocompetent boy showed a disseminated uveitis with patchy thickening of the posterior choroid. A clinical neurologic examination and a microbiological assessment revealed neck stiffness as well as pleocytosis, increased protein content, a decreased concentration of glucose and chloride, and cryptococcal fungi in the cerebrospinal fluid. It led to the diagnosis of cryptococcal meningitis.Antifungal therapy was initiated and given for 2 months. After bilateral retrobulbar injections of 2.5 mg of dexamethasone and 20 mg of triamcinolone acetonide, choroidal edema regressed and visual acuity increased from 0.4 to 1.0 at 3 weeks after start of therapy. Microbiological examination of cerebrospinal fluid samples taken 30 days later was unremarkable. Ophthalmoscopy showed some fine pigment clumping and depigmentation in the macula.According to the International Nomenclature Committee for Vogt-Koyanagi-Harada diagnosis, the patient was diagnosed with incomplete Vogt-Koyanagi-Harada because he had not suffered any ocular trauma, had not undergone ocular surgery, and presented with bilateral multifocal choroiditis accompanied by signs of meningitis without skin abnormalities. Because skin changes can occur months to years after the initial symptoms, the patient may eventually fulfill the criteria for complete Vogt-Koyanagi-Harada disease.
基金:
Supported by the Research Fund of Capital Medical Development
(2009-3155) and the Beijing Nova Program (2010B032)
语种:
外文
PubmedID:
第一作者:
第一作者机构:[1]Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
通讯作者:
通讯机构:[2]Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Sciences Key Laboratory[*1]Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Hospital, 1 Dong Jiao Min Xiang, Dong Cheng District, 100730 Beijing, China
推荐引用方式(GB/T 7714):
You Qi Sheng,Peng Xiao Yan,Zhang Xiao Jun,et al.Vogt-Koyanagi-Harada disease and fungal meningitis.[J].Retinal cases & brief reports.2013,7(4):412-5.doi:10.1097/ICB.0b013e318297f6f9.
APA:
You Qi Sheng,Peng Xiao Yan,Zhang Xiao Jun,Meng Chao,Peng Jing Ting&Jonas Jost B.(2013).Vogt-Koyanagi-Harada disease and fungal meningitis..Retinal cases & brief reports,7,(4)
MLA:
You Qi Sheng,et al."Vogt-Koyanagi-Harada disease and fungal meningitis.".Retinal cases & brief reports 7..4(2013):412-5