个案报道：颅内动脉瘤介入术后暴发性内源性眼内炎1例

Fulminant Endogenous Endophthalmitis Following Intracranial Aneurysm Intervention: A Case Report

摘要: 患者女，69岁，因左侧后交通动脉瘤破裂伴蛛网膜下腔出血行介入栓塞术，术后12日患者初发右眼胀痛、眶压升高，起病表现隐匿，仅以眼压升高、眼部胀痛为主要表现，病情在72小时内呈暴发性进展，迅速发展为眼眶蜂窝织炎、继而出现眼球组织广泛溶解，最终行眼球摘除术。内源性眼内炎为颅内介入术后少见并发症，由全身隐匿性感染经血行播散至眼内所致，本例以病程进展极快、组织破坏性极强为突出特点。通过对本例临床经过总结，结合相关文献分析发病机制与诊疗要点，旨在提高临床对暴发性内源性眼内炎的认识，重视其急速恶化的临床特征，为高危患者的早期识别与干预提供参考。

Abstract: A 69-year-old female patient received interventional embolization for ruptured left posterior communicating artery aneurysm with subarachnoid hemorrhage. Twelve days postoperatively, the patient developed right eye distending pain and increased orbital pressure. Characterized by an insidious onset, the disease initially presented merely with elevated intraocular pressure and ocular soreness. The condition progressed fulminantly within 72 hours, rapidly evolving into orbital cellulitis and extensive ocular tissue dissolution, which ultimately necessitated ocular enucleation. Endogenous endophthalmitis is a rare postoperative complication of intracranial intervention, caused by the hematogenous dissemination of occult systemic infection. This case is distinguished by extremely rapid deterioration and severe ocular tissue destruction. By summarizing the clinical course and reviewing relevant literature, this article analyzes the pathogenesis, diagnosis and therapeutic key points of the disease, aiming to enhance clinicians’ recognition of fulminant endogenous endophthalmitis, highlight its rapidly progressive features, and provide evidence for early identification and standardized intervention for high-risk patients.