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细菌性心内膜炎以神经病学并发症为早期表现者罕见,一但出现,即很严重或致命。作者介绍1例细菌性心内膜炎早期双侧皮质性失明患者。患者,女,37岁,双眼完全失明入院。自诉数天前开始出现视力减退,逐渐发展为仅有光感。两、三天前曾有额枕部疼痛,头晕.行走困难,发热。及胸骨后疼痛。否认近期头部外伤、高血压、偏头痛及脑血管病史。有静脉内吸毒史10年,有贫血、瓣膜性心脏病及乙肝史,HIV 阴性。查体:病人呈恶液质,嗜睡。口温38.1℃,其余生命体征正常。瞳孔等大、光反射存在。无角膜混浊及视神经乳头水肿,无巩膜及结膜出血、渗出或充
Bacterial endocarditis with neurological complications as an early manifestation of rare, but when it occurs, that is very serious or fatal. The authors present a case of early bilateral cortical blindness in patients with bacterial endocarditis. Patient, female, 37 years old, both eyes totally blind and admitted to hospital. Prosecution began a few days ago, vision loss, and gradually developed into only light perception. Two or three days ago there was a pillow pain, dizziness. Difficult to walk, fever. And sternal pain. Denied the recent history of head trauma, hypertension, migraine and cerebrovascular disease. A history of intravenous drug abuse 10 years, anemia, valvular heart disease and hepatitis B history, HIV-negative. Physical examination: the patient was evil liquid, lethargy. Mouth temperature 38.1 ℃, the remaining vital signs normal. Pupil and other large, light reflection exists. No corneal opacity and papilledema, no scleral and conjunctival hemorrhage, exudation or filling