论文部分内容阅读
目的:报告1例罕见的以眼眶脓肿为主要表现,大剂量头孢他定静脉给药治疗成功的类鼻疽。方法:眼眶类鼻疽病例报告1例。结果:一名55岁的马来人,新近诊断为糖尿病,低热3wk,左眼肿胀5d入院。头颅及眼眶CT显示左眼眶蜂窝织炎和左侧急性蝶窦炎,最初上眼睑瘘管拭子培养结果为假单胞菌属,给予常规抗生素治疗,患者的全身情况改善。然而随着持续静脉给药,患者全身情况开始恶化,左眼变得更加突出,复查头颅及眼眶CT显示左眼眶脓肿并颅内扩散形成脑脓肿。来自上眼睑侧部瘘管的拭子培养结果显示类鼻疽假单胞菌,急性期采用大剂量头孢他定静脉治疗并口服复方增效磺胺,后采用复方增效磺胺维持治疗2mo治愈,观察1a未见复发。不幸的是患者的左眼视力丧失。结论:这是1例罕见的由类鼻疽引起的伴发脑脓肿和败血症的眼眶脓肿。在正确诊断的前提下,同时应用大剂量敏感抗生素可有效治疗这种严重疾病。
OBJECTIVE: To report a rare case of orbital abscess as the main manifestation of high-dose ceftazidime administered successfully in the treatment of gonorrhea. Methods: Orbital ganglion cases reported in 1 case. Results: A 55-year-old Malay was recently diagnosed with diabetes mellitus, fever 3wk, left eye swelling 5d admission. Head and orbital CT showed left orbital cellulitis and left acute sphenoid sinusitis, the initial upper eyelid fistula swab culture results for the Pseudomonas genus, given conventional antibiotic therapy, the patient’s general condition improved. However, with continued intravenous administration, the general condition of the patient started to deteriorate and the left eye became more conspicuous. Review of the cranial and orbital CT revealed left orbital abscess and intracranial diffusion to form a brain abscess. From the fistula on the upper eyelid fistula culture results showed that the type of Pseudomonas aeruginosa, acute high-dose ceftazidime therapy and oral compound synergistic sulfa, with compound synergistic sulfonamide maintenance treatment 2mo cure, the observation 1a did not see relapse. Unfortunately, the patient’s left eye has loss of vision. CONCLUSIONS: This is a rare case of orbital abscess associated with brain abscesses and septicemia caused by idiopathic ganglia. In the correct diagnosis of the premise, while the application of high-dose sensitive antibiotics can effectively treat this serious disease.