| A Case of Aspergillus Endophthalmitis as a Preceding Symptom of Central Nervous System Lymphoma. |
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Jae Min Kim, Ho Geol Woo, Dokyung Lee, Hyung Woo Kwak, Tae Beom Ahn |
1Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Korea.
2Department of Neurology, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Korea. ricash@hanmail.net |
| 아스페르길루스 안내염이 선행한 중추신경계림프종 1예 |
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김재민1⋅우호걸2⋅이도경2⋅곽형우1⋅안태범2 |
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경희대학교 의학전문대학원 경희대학교병원 안과학교실1, 경희대학교 의과대학 경희대학교병원 신경과학교실2 |
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Correspondence:
Tae Beom Ahn |
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Received: 15 October 2015 • Revised: 20 December 2015 • Accepted: 13 February 2016 |
| Abstract |
PURPOSE
To report a rare case of Aspergillus endophthalmitis as a preceding symptom of central nervous system (CNS) lymphoma. CASE SUMMARY: A 66-year-old female was admitted to our clinic with mental change for 3 days. Seven months earlier, she had been diagnosed with retinal vasculitis in an ophthalmology clinic because of blurred vision in both eyes and was administered steroid therapy. Three months earlier, because of progressive symptoms, vitreous fluid culture had been performed and showed Aspergillus endophthalmitis. She was treated with intravitreous voriconazole injection and oral voriconazole. Initial brain magnetic resonance imaging (MRI) and cerebrospinal fluid study was normal. Two months later, a second MRI showed multiple enhancing lesions, which were aggravated on the third MRI at admission to our clinic. Although brain biopsy was not performed due to the poor condition of the patient, CNS lymphoma was suspected based on the neuroimaging. After steroid pulse therapy and whole brain radiation, follow-up neurologic examination showed improved mental state, and follow-up MRI showed remarkable shrinkage of multiple lesions. CONCLUSIONS: As Aspergillus endophthalmitis is an opportunistic infection in those with an immune-compromised state and the orbit is near the central nervous system, the clinician should be alert to concomitant disorders in CNS. For a prompt and accurate diagnosis of CNS disorder, early evaluation of neurologic symptoms beyond symptoms of endophthalmitis and neuroimaging is essential. |
| Key Words:
Aspergillus;Central nervous system (CNS) lymphoma;Endophthalmitis |
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