目的:报告1例免疫功能正常的患者患复发性后天性眼弓形体病的异常恶化及治疗后视力的改善。方法:病例报告。结果:比沙亚族女孩,21岁,其它方面健康,有与猫接触史,表现为右眼无痛、渐进性视力模糊2wk。视力右眼6/15,左眼6/6。眼底检查呈右眼后极部局灶性视网膜炎,伴视盘肿胀充血,双眼周边陈旧性视网膜脉络膜疤痕。经弓形虫血清检查证实其右眼患复发性眼弓形虫病。起初,患者对复方新诺明和阿奇霉素两种药物反应良好。然而在治疗过程中患者右眼弓形体病两次恶化,右眼视力下降到6/60,随后进行持续6wk的口服阿奇霉素和逐渐减量的皮质类固醇药物治疗,右眼弓形虫性视网膜炎治愈,随访1a未见复发。患者最终视力,右眼6/30,左眼6/6。结论:患复发性后天性眼弓形体病在免疫功能正常的个体并不常见。延误诊断和治疗导致永久性失明。及时、充分的治疗和良好的治疗依从性对防止并发症毁坏视觉极其重要。

AIM:To report unusual exacerbation of recurrent acquired ocular toxoplasmosis and improvement of visual outcome with proper treatment in an immunocompetent individual.METHODS:Case report.RESULTS:A 21-year-old Bisaya girl,otherwise healthy,with contact history with cats,presented with right eye painless and progressive blurring of vision for two weeks.The visual acuity was 6/15 in the right eye and 6/6 in the left eye.Fundus examination showed focal retinitis in the posterior pole with swollen hyperemic optic disc in the right eye and old retinochoroidal scars in the periphery of both eyes.She had right recurrent ocular toxoplasmosis that was confirmed with toxoplasma serology.Initially,she responded to two different treatments such as bactrim and azithromycin.Unfortunately,she developed two episodes of exacerbation of toxoplasmosis in right eye during the course of treatment.Her right eye visual acuity was decreased to 6/60.The medication regime consisted of oral azithromycin with tapering doses of corticosteroids was subsequently initiated in this patient for 6 weeks.The toxoplasmic retinitis in the right eye was resolved and there was no recurrence during the last 1 year follow-up.Her final visual acuity was 6/30 in right eye and 6/6 in left eye.CONCLUSION:Recurrent acquired ocular toxoplasmosis in an immunocompetent individual is not common.Delayed diagnosis and treatment result in permanent blindness.Prompt,adequate and compliance of treatment are essential to prevent this devastating visual complication.

R531.8