Clinical Features and Multimodal Imaging in Atypical Posterior Uveitis Secondary to Bartonella Henselae Infection.
Clinical Features and Multimodal Imaging in Atypical Posterior Uveitis Secondary to Bartonella Henselae Infection.
复制标题
汉赛巴尔通体感染继发的非典型后葡萄膜炎的临床特征和多模态成像。
DOI：
10.1080/09273948.2021.1961812
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发表时间：
2022
影响因子：
3.3
通讯作者：
Bonhomme,GabrielleR
中科院分区：
文献类型：
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作者：
Koretz,ZacharyA;Apostolopoulou,Anna;Chen,Edwin;Beale,Oliver;Veldkamp,Peter;Viehman,JohnAlex;Sahel,José-Alain;Chhablani,Jay;Dansingani,KunalK;Errera,Marie-Hélène;Bonhomme,GabrielleR
PurposeTo表征一个不寻常的介绍感染性后葡萄膜炎使用多模态成像，并讨论参与诊断和treatment.MethodsWide-field眼底照相，扫频源光学相干断层扫描（OCT），扫频源OCT血管造影，荧光素血管造影，和吲哚菁绿色angiography.ResultsThis患者提出了周期性发热和视力模糊的临床决策。眼底检查显示双侧视盘水肿，黄斑部视网膜内白色斑点和许多散在的黄白色脉络膜视网膜病变。多模态影像学特征提示这些病变中有许多是脉络膜肉芽肿。广泛的全身检查是唯一值得注意的边界线升高巴尔通体IgG滴度（1：128），但恢复期IgG滴度升高，在38天（1：512）支持诊断巴尔通体chorioretinits.ConclusionOcular表现巴尔通体henselae感染是多种多样的，可能包括脉络膜肉芽肿。多模态成像特征可能有助于确定感染性葡萄膜炎的病因。在评估疑似巴尔通体病患者时，恢复期滴度非常重要，尤其是非典型表现的患者。
PurposeTo characterize an unusual presentation of infectious posterior uveitis using multimodal imaging, and discuss the clinical decision-making involved in diagnosis and treatment.MethodsWide-field fundus photography, swept-source optical coherence tomography (OCT), swept-source OCT angiography, fluorescein angiography, and indocyanine green angiography.ResultsThis patient presented with cyclical fevers and blurry vision. Fundus examination revealed bilateral optic disc edema, macular intraretinal white spots and many scattered yellow-white chorioretinal lesions. Multimodal imaging characteristics suggested that many of these lesions represent choroidal granulomas. Extensive systemic workup was only notable for borderline elevated Bartonella henselae IgG titers (1:128), however convalescent IgG titers were elevated at 38 days (1:512) supporting the diagnosis of Bartonella chorioretinitis.ConclusionOcular manifestations of Bartonella henselae infection are varied and may include choroidal granulomas. Multimodal imaging characteristics may help identify etiologies of infectious uveitis. Convalescent titers are important when evaluating patients with suspected Bartonellosis, especially patients with atypical presentations.