아스퍼질루스균에 의한 내인성 안내염 환자에서 뇌 기저 동맥 감염 동맥류가 동반된 증례
Cerebral Basilar Artery Mycotic Aneurysm Associated With Aspergillus Endogenous Endophthalmitis
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목적: 아스퍼질루스균에 의한 양안의 내인성 안내염 환자에서 뇌 기저 동맥의 감염 동맥류가 발생한 증례를 보고하고자 한다. 증례 요약: 기저 질환이 없는 41세 남자 환자가 양안의 시력 저하를 주소로 내원하였다. 양안의 내인성 안내염이 의심되어 우안의 유리 체절제술 및 수정체제거술을 시행하였다. 유리체액에서 균사가 확인되어 전신적으로 암포테리신 치료를 받기 시작하였다. 수술 후 3일째 지주막하 출혈이 발생하여 혼수 상태에 빠졌다. 유리체액 및 뇌척수액에서 아스퍼질루스균 항원이 확인되어, 지주막하 출혈은 아스퍼질루스균에 의한 중추 신경계 감염에 합병된 뇌 기저 동맥의 감염 동맥류 파열에 의한 것으로 진단하였다.
Abstract
Purpose: To report a case of mycotic aneurysm of the cerebral basilar artery associated with bilateral endogenous aspergillus endophthalmitis. Case summary: A 41-year-old man with no underlying disease presented with decreased vision in both eyes. The patient was diagnosed with bilateral endogenous endophthalmitis, and the authors performed a vitrectomy and lensectomy on the right eye. Hyphae were detected in the vitreous sample, and systemic amphotericin was administered. Three days after the operation, the patient became comatose due to a subarachnoid hemorrhage. Aspergillus antigen was detected in the vitreous sample and in the cerebrospinal fluid. Subarachnoid hemorrhage was due to the rupture of a mycotic aneurysm of the cranial basilar artery, complicated by aspergillus infection of the central nervous system.
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