尿路感染伪装成神经炎光学谱障碍恶化:一个病例报告
João Mendes1, Sanjana Jaiswal2, Safa Ibrahim2
1Hospital do Espírito Santo de Évora, Évora, Portugal.
Case reports in ophthalmology
|January 16, 2026
概括
尿路感染可以模仿神经髓炎光学谱系障碍 (NMOSD) 的复发,特别是在老年人中,免疫抑制患者. 及时诊断和抗生素治疗缓解了症状,强调了在NMOSD恶化时考虑感染的重要性.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
背景情况:
- 神经脊髓炎光学谱系障碍 (NMOSD) 是一种严重的自身免疫性脱髓化疾病.
- 区分NMOSD复发与感染诱导的伪恶化非常重要,特别是在免疫受损的个体中.
- 老年患者的非典型表现进一步使诊断复杂化.
研究的目的:
- 在老年患者中报告一个模仿NMOSD复发的尿路感染病例.
- 强调在NMOSD管理中感染所带来的诊断挑战.
- 强调考虑症状恶化的非炎症原因的重要性.
主要方法:
- 一个83岁的女性患有AQP4-IgG阳性NMOSD和帕金森病的案例介绍.
- 临床评估包括神经眼科检查和磁共振成像 (MRI).
- 实验室调查,包括尿液分析和尿液培养;治疗反应评估.
主要成果:
- 患者出现视力损失和精神状态变化,最初被认为是NMOSD复发.
- 尽管接受了皮质类固醇治疗,但症状恶化;MRI显示没有新的脱髓化病变.
- 诊断出尿路感染 (Klebsiella oxytoca),抗生素治疗导致症状缓解和视力恢复.
结论:
- 尿路感染可以呈现为NMOSD的伪恶化.
- 感染可能会使老年,免疫抑制的NMOSD患者的诊断和治疗复杂化.
- 及时识别和治疗感染对于NMOSD患者的良好结果至关重要.
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