tailieunhanh - Báo cáo y học: "Institute of Ophthalmology, University “La Sapienza” of Rome (Italy"

Tuyển tập các báo cáo nghiên cứu khoa học ngành y học tạp chí Medical Sciences dành cho các bạn sinh viên ngành y tham khảo đề tài: Institute of Ophthalmology, University “La Sapienza” of Rome (Italy). | Int. J. Med. Sci. 2009 6 131 International Journal of Medical Sciences 2009 6 3 131-132 Ivyspring International Publisher. All rights reserved Short Communication Ocular Bartonellosis Massimo Accorinti Institute of Ophthalmology University La Sapienza of Rome Italy Published Bartonella henselae is a gram negative aerobic bacillus and is the etiologic agent of cat-scratch disease. The infection is present around the world and may affect patients of all ages including immunocompetent individuals. Humans are usually infected through a cat s scratch or bite but a bite by cat fleas may also be the origin of infection. More common in children and young adults it usually presents with a wide range of systemic and ocular symptoms. Other Bartonella species have been described as causing ocular lesions as shown in Table 1. Systemic signs and symptoms usually precede ocular involvement and are constituted by the appearance 3 to 10 days after inoculation of bartonella by scratch or bite of an erythematous papule on the skin on the site of inoculation. Seven to 14 days after the exposure a follicular conjunctivitis may appear. Fourteen to 21 days after the inoculation regional lymphoadenopathy may occur which is usually associated with myalgias fatigue and low-grade fever. The association of conjunctivits and regional lym-phoadenopathy is well known as Parinaud s oculo-glandular syndrome POGS . Ocular signs The most frequent ocular manifestation is neuroretinitis which is usually unilateral. If neuroretinitis is bilateral it is quite asymmetric. Rarely posterior pole involvement may be characterized by the presence of a focal inflammatory mass either of the retina or of the optic disk. Central or paracentral scotoma or physiologic blind spot enlargement are the main alterations of the visual field while fluorescein angiography usually presents a diffuse leakage from the optic nerve head along with the retinal vessels. Sometimes vascular occlusion with intraretinal .