摘要
患者女性，78岁，因左眼视物模糊伴眼红2周就诊于我院眼科。患者发病5周前因“胆囊结石合并肝外胆管结石”行I期“腹腔镜胆囊切除术”，4周前行II期“经内镜逆行胰胆管造影术”。眼科检查示双眼非肉芽肿性炎症伴致密性玻璃体炎，玻璃体切除术中发现双眼玻璃体和视网膜散在黄白色“茸球状”病灶及左眼伴视网膜裂孔，左眼房水及右眼玻璃体液宏基因检测均发现近平滑念珠菌，基于高龄、两次胆道手术史的高危因素、典型眼底表现及宏基因检测结果，该病例诊断为胆道术后所致的双眼内源性真菌性眼内炎。
关键词： 胆道术后；内源性真菌性眼内炎；近平滑念珠菌
Abstract
The patient is a 78-year-old woman who complained of painless blurred vision and redness in the left eye for 2 weeks. Due to diagnosis of gallstones complicated with extrahepatic bile duct stones, she underwent a primary laparoscopic cholecystectomy and second endoscopic retrograde cholangiopancreatography 5 weeks and 4 weeks ahead of the onset of her ocular symptoms, respectively. Ocular examination revealed non granulomatous inflammation with dense vitritis of both eyes. Vitrectomy was performed and intraoperative findings included bilateral white-yellowish ball lesions in the vitreous and retina with retinal tear in the left eye. Next generation sequencing analysis of a vitreous sample of right eye and aqueous humor of left eye detected the candida parapsilosis. Based on clinical presentation, risk factors and examination findings, a diagnosis of bilateral endogenous fungal endophtalmitis associated with biliary tract post-operation was established.
Key words： Biliary tract post-operation; Endogenous fungal endophtalmitis; Candida parapsilosis
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