敬請指教

本人才疏學淺,懇請諸位先進前輩不吝指正。歡迎光臨:空中視力保健室

2011年1月21日 星期五

眼窩結核–Ocular Tuberculosis

Ocular Tuberculosis – OTB

流病:

未開發國家:結核疫區
開發中國家:都市內貧民區
近來報告以children居多

好發: HIV, immune compromised

傳佈:
hematogenous route from pulmonary focus (多)
tuberculous sinusitis (少)

症狀: Proptosis, motility dysfunction, bone destruction, chronic draining fistula.

「單側」發病居多!

容易與orbital malignancy混淆
誤診為Pseudotumor而用corticosteroids可能加重病程


Diagnosis:

Skin test, FNAB with culture early for diagnosis.
Acid-fast bacilli from pathological sepcimens(困難)

病理: Chronic inflammatory process: periositits (Cold Abscess)
caseating necrosis, epitheloid cells, Langhans giant cells.

治療: Antituberculous medical therapy.