Diagnostic microbiology and infectious disease · 2025
The first reported case of combined occlusion of branch retinal artery and vein secondary to disseminated mycobacterium kansasii infection.
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Luo Yanhua, Lin Binwu, Luo Baohua, Qin Lin, Pang Long
Аннотация
BACKGROUND: Combined occlusion of branch retinal artery and vein in young patient is rare and indicates a high risk of underlying systemic disease. Retinal arteriovenous occlusion secondary to Mycobacterium kansasii (M. kansasii) infection has never been reported.
CASE PRESENTATION: A 37-year-old woman, previously healthy and with nothing remarkable in her family history, presented to the ophthalmology clinic due to a 1-week history of blurred vision and inferior shadow of her right eye. She had been experiencing coughing with phlegm for one month prior to the eye symptoms. Upon examination, it was found that she had a simultaneous occlusion of branch retinal artery and branch retinal vein. Laboratory investigations revealed significant inflammation and hypercoagulability. Computed tomography revealed abnormally intense metabolic activity affecting the lungs, mediastinum, spleen, nasopharynx, neck, and bones. After three months, M. kansasii was identified through DNA sequencing of pathological tissue sections, leading to a diagnosis of disseminated M. kansasii infection. Although the medications (Rifampin, Isoniazid, Ethambutol, Clarithromycin) were administered according to standardized diagnostic and therapeutic guidelines as soon as the diagnosis was made, the patient was unable to complete the full course of medications due to her inability to tolerate the side effects of the medications. The patient's condition eventually worsened and resulted in death.
CONCLUSIONS: This is the first case of M. kansasii-associated hypercoagulability resulting in retinal arteriovenous occlusion. Disseminated Mycobacterium kansasii (DMK) infection is a rare but serious disease that can affect multiple organ systems. Rare retinal arteriovenous occlusion in young patients is often indicative of systemic disease and requires thorough evaluation to avoid misdiagnosis.
CASE PRESENTATION: A 37-year-old woman, previously healthy and with nothing remarkable in her family history, presented to the ophthalmology clinic due to a 1-week history of blurred vision and inferior shadow of her right eye. She had been experiencing coughing with phlegm for one month prior to the eye symptoms. Upon examination, it was found that she had a simultaneous occlusion of branch retinal artery and branch retinal vein. Laboratory investigations revealed significant inflammation and hypercoagulability. Computed tomography revealed abnormally intense metabolic activity affecting the lungs, mediastinum, spleen, nasopharynx, neck, and bones. After three months, M. kansasii was identified through DNA sequencing of pathological tissue sections, leading to a diagnosis of disseminated M. kansasii infection. Although the medications (Rifampin, Isoniazid, Ethambutol, Clarithromycin) were administered according to standardized diagnostic and therapeutic guidelines as soon as the diagnosis was made, the patient was unable to complete the full course of medications due to her inability to tolerate the side effects of the medications. The patient's condition eventually worsened and resulted in death.
CONCLUSIONS: This is the first case of M. kansasii-associated hypercoagulability resulting in retinal arteriovenous occlusion. Disseminated Mycobacterium kansasii (DMK) infection is a rare but serious disease that can affect multiple organ systems. Rare retinal arteriovenous occlusion in young patients is often indicative of systemic disease and requires thorough evaluation to avoid misdiagnosis.