非感染性葡萄膜炎引起囊狀黃斑部水腫合併產生視神經發炎

The Appearance of Optic Neuritis in Non-Infectious Uveitis with Cystoid Macula Edema

本文宗旨：報告一位23歲女性和41歲男性罹患非感染性葡萄膜炎，引起囊狀黃斑部水腫並合併產生視神經炎，使用口服類固醇成功治療的兩個病患。方法：回顧性病例報告。結果：病例1是23歲女性主訴雙眼模糊，雙眼呈現玻璃體炎、囊狀黃斑部水腫和視神經炎。病例2是41歲有HLA-B27陽性前房葡萄膜炎病史的男性，主訴打完COVID-19高端疫苗一天後右眼模糊，右眼呈現玻璃體炎、囊狀黃斑部水腫和視神經炎。腦部核磁共振呈現視神經顯影增加，確立視神經炎診斷。兩位病患使用局部和口服類固醇藥物後逐漸好轉，黃斑部水腫和視神經炎完全改善，6個月後追蹤沒有復發。結論：平坦部炎相關的非感染性葡萄膜炎，可以合併產生視神經炎。有可能因為相同基因例如HLA-DR15介入而造成兩者疾病。

 

Spinal epidural abscess is an uncommon but critical central nervous infection. It can be life threatening and result in severe morbidity. We presented with a case of pan-spinal epidural abscess with relation to deep neck infection, empyema and shock. He had sudden quadriplegia with numbness below shoulder, unstable hemodynamic status and respiratory failure. Emergency intubation, surgical debridement of the em-pyema and prescription of antibiotics were the initial treatments. His vital signs grad-ually stabilized and then he received surgical decompression of C1-3 laminectomy and debridement of the spinal abscess. After the antibiotic treatment and rehabilitation for 6 weeks his hands and legs weakness got much improving and can have oral intake by himself. Pan-spinal epidural abscess usually involves many other medical problems, therefore resulting poor physical condition and poor prognosis. With interdisciplinary teamwork and critical care medicine there is more and more evidence supporting that surgical intervention with antibiotic treatment and rehabilitation is recommended for the patient with pan-spinal epidural abscess