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目的:报告1例免疫功能正常的患者患复发性后天性眼弓形体病的异常恶化及治疗后视力的改善。方法:病例报告。结果:比沙亚族女孩,21岁,其它方面健康,有与猫接触史,表现为右眼无痛、渐进性视力模糊2wk。视力右眼6/15,左眼6/6。眼底检查呈右眼后极部局灶性视网膜炎,伴视盘肿胀充血,双眼周边陈旧性视网膜脉络膜疤痕。经弓形虫血清检查证实其右眼患复发性眼弓形虫病。起初,患者对复方新诺明和阿奇霉素两种药物反应良好。然而在治疗过程中患者右眼弓形体病两次恶化,右眼视力下降到6/60,随后进行持续6wk的口服阿奇霉素和逐渐减量的皮质类固醇药物治疗,右眼弓形虫性视网膜炎治愈,随访1a未见复发。患者最终视力,右眼6/30,左眼6/6。结论:患复发性后天性眼弓形体病在免疫功能正常的个体并不常见。延误诊断和治疗导致永久性失明。及时、充分的治疗和良好的治疗依从性对防止并发症毁坏视觉极其重要。
OBJECTIVE: To report the abnormal deterioration of recurrent acquired Otorhinolaryngology and the improvement of visual acuity after treatment in 1 patient with normal immune function. Methods: Case report. Results: Bixian girls, age 21, were otherwise healthy and had contact history with cats, showing painless right eye and progressive blurred vision 2wk. Right eye 6/15, left 6/6. Fundus examination showed the right posterior pole of focal retinitis, with disc swelling and congestion, eyes around the old retinal choroidal scar. Toxoplasma serodiagnosis confirmed that the right eye had recurrent ocular toxomatosis. At first, patients responded well to both cotrimoxazole and azithromycin. However, during the course of treatment, the patient’s right eye toxoplasmosis deteriorated twice, his right eye decreased to 6/60, followed by 6 weeks of oral azithromycin and tapering corticosteroid therapy, right eye Toxoplasma retinitis cured, Follow-up la no recurrence. The patient’s final visual acuity was 6/30 in the right eye and 6/6 in the left eye. Conclusions: Patients with recurrent acquired ocular toxoplasmosis are uncommon in individuals with normal immune function. Delayed diagnosis and treatment lead to permanent blindness. Timely, adequate treatment and good treatment compliance are extremely important in preventing complications from damaging the vision.