Severe Cocaine-Induced Midline Destructive Lesions (CIMDL) Leading to Orbital Apex Syndrome and Peripheral Ulcerative Keratitis
| Autor: | Alberto Comín Pérez, Amparo Ortiz-Seller, Elia Valls Pascual, Mara Albert-Fort, Antonio Hernández-Pons, Raquel Dolz Gaitón |
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| Rok vydání: | 2021 |
| Předmět: |
030203 arthritis & rheumatology
medicine.medical_specialty genetic structures business.industry corneal ulcer medicine.disease medicine.disease_cause Dermatology eye diseases Peripheral ulcerative keratitis Autoimmunity 03 medical and health sciences Ophthalmology 0302 clinical medicine 030221 ophthalmology & optometry Mydriasis Immunology and Allergy Medicine Optic disc swelling Respiratory system medicine.symptom business Sinusitis Orbital apex |
| Zdroj: | Ocular immunology and inflammation. 30(7-8) |
| ISSN: | 1744-5078 |
| Popis: | Purpose: To describe a case of cocaine-induced midline destructive lesions (CIMDL) associated with ocular autoimmune disease.Methods: Observational case report.Results: A 45-year-old man with history of chronic osteolytic sinusitis due to cocaine abuse presented with sudden vision loss in right eye. Ophthalmic examination revealed fixed right mydriasis with extraocular movements limitation and optic disc swelling. Computed tomography showed an orbital infiltrating mass. The diagnosis of orbital-apex syndrome secondary to CIMDL was established. Steroids and antibiotics therapy were started without vision improvement. At 6-months follow-up, a corneal ulcer with characteristics of peripheral ulcerative keratitis (PUK) was evidenced, coinciding with an upper respiratory bacterial infection.Conclusions: CIMDL and PUK share common pathogenic pathways, with implication of autoimmune factors and exposure to infective antigens. We hypothesized that chronic cocaine use, along with persistent bacterial infection, could have triggered an inflammatory reaction, which contributed to CIMDL development and the appearance of PUK. |
| Databáze: | OpenAIRE |
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