RESUMO
INTRODUCTION: Acute retinal necrosis syndrome (ARN syndrome) is a rare viral disease with a poor prognosis in most cases. It is characterized by substantial ocular inflammation with progressive retinal necrosis, occlusive vasculitis and sometimes extraocular features. CASE REPORT: We report the case of a 62-year-old woman who was referred for a suspicion of a stroke. Ophthalmological examination revealed a profound bilateral visual loss due to extensive retinal necrosis. The patient was immediately treated with antiherpetic drugs. ARN syndrome with meningoencephalitis caused by herpes simplex virus type 2 was confirmed by PCR studies performed on aqueous humor and cerebrospinal fluid. Herpes simplex virus 2 (IgG+ , IgM-) was probably reactivated after intrathecal injection of steroids because of pain associated with narrowing of the lumbar vertebral canal. The patient was treated with intravenous Acyclovir for 3 weeks. After 4 months, both retinas were detached. DISCUSSION AND CONCLUSION: ARN syndrome caused by herpes simplex virus 2 most often occurs after reactivation of the latent virus in patients with a neurological medical history or congenital infection. Antiviral treatment must begin early to decrease risks of bilateralization and complications.
Assuntos
Erros de Diagnóstico , Encefalite por Herpes Simples/complicações , Herpesvirus Humano 2/isolamento & purificação , Síndrome de Necrose Retiniana Aguda/etiologia , Aciclovir/uso terapêutico , Antivirais/uso terapêutico , Humor Aquoso/virologia , Líquido Cefalorraquidiano/virologia , DNA Viral/análise , Dexametasona/administração & dosagem , Dexametasona/uso terapêutico , Quimioterapia Combinada , Encefalite por Herpes Simples/tratamento farmacológico , Encefalite por Herpes Simples/virologia , Feminino , Ganciclovir/uso terapêutico , Hemiplegia/etiologia , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Descolamento Retiniano/etiologia , Síndrome de Necrose Retiniana Aguda/diagnóstico , Síndrome de Necrose Retiniana Aguda/tratamento farmacológico , Síndrome de Necrose Retiniana Aguda/virologia , Acidente Vascular Cerebral/diagnóstico , Incontinência Urinária/etiologia , Ativação ViralRESUMO
A clinico-pathologic case of an oncocytoma of the caruncle is reported in a 60-year old male patient. Clinically a granular reddish painless tumor was observed in the caruncle. A total surgical excision was performed. The histopathological study established the diagnosis of oncocytoma of the caruncle. Although rare, this tumor should be recognized by ophthalmologists, specially in elderly, because of exceptional adenocarcinoma. The oncocytoma is cured by surgical excision.