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首页> 外文期刊>BMC Ophthalmology >Necrotizing herpetic retinopathy in an immune-compromised pediatric patient with minimal signs of inflammation: case report
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Necrotizing herpetic retinopathy in an immune-compromised pediatric patient with minimal signs of inflammation: case report

机译：免疫功能低下，发炎迹象极少的小儿坏死性疱疹性视网膜病：病例报告

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Background To report a case of necrotizing herpetic retinopathy(NHR) in an immuno-compromised pediatric patient. Case presentation An 11-year-old boy presented with a minimal ocular foreign-body sensation and peripheral visual-field defect, as well as mild upper respiratory symptoms. He had undergone the Fontan operation for a ventricular septal defect and single ventricle during infancy, and had been taking oral steroids for 1?year immediately prior to his presentation to treat protein-losing enteropathy. Initially, a case of either cytomegalovirus (CMV) retinitis or acute retinal necrosis (ARN) was suspected, and an intravenous course of ganciclovir and acyclovir was therefore initiated. During treatment, varicella-zoster virus (VZV) was detected in the anterior chamber, and ARN was confirmed when both serum and aqueous humor were found by polymerase chain reaction (PCR) to be positive for VZV DNA. A peripheral retinal break and detachment developed after medical treatment, and a vitrectomy was performed. Conclusions Typically, ARN is found in both healthy individuals and subclinically immuno-compromised patients of any age. CMV retinitis is somewhat more typical for immuno-compromised patients. Herein, we report a case of NHR in a pediatric patient with poor general condition and showing minimal signs of inflammation.
机译：背景要报道一例免疫功能低下的小儿患者坏死性疱疹性视网膜病（NHR）的病例。病例介绍一个11岁的男孩表现出最少的眼部异物感和周围视野缺损，以及轻度的上呼吸道症状。他在婴儿期因室间隔缺损和单心室接受了Fontan手术，并且在就诊前即刻服用口服类固醇激素治疗了1年。最初，怀疑是巨细胞病毒（CMV）视网膜炎或急性视网膜坏死（ARN）的病例，因此开始了更昔洛韦和阿昔洛韦的静脉内疗程。在治疗过程中，在前房中检测到水痘带状疱疹病毒（VZV），并且当通过聚合酶链反应（PCR）发现血清和房水均对VZV DNA呈阳性时，证实了ARN。药物治疗后出现周围性视网膜断裂和脱离，并进行了玻璃体切除术。结论通常，在任何年龄的健康个体和亚临床免疫功能低下的患者中都可以发现ARN。对于免疫功能低下的患者，CMV视网膜炎更为典型。本文中，我们报告了一名一般状况较差且发炎迹象极少的小儿患者的NHR病例。

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