重症眼眶蜂窝织炎样Sweet综合征一例

Sweet Syndrome Mimicking Severe Orbital Cellulitis: A Case Report

摘要: 目的：探讨重症眼眶蜂窝织炎样Sweet综合征的临床表现及诊断要点，分析疾病进展过程及误诊原因，总结治疗方案。方法：回顾性分析1例75岁老年男性的临床资料。患者因左眼上睑皮肤软组织高度肿胀、充血伴发热入院，初期误诊为细菌性眼眶蜂窝织炎，经抗生素治疗无效，病情迅速进展。患者既往骨髓纤维化病史，经皮损活检及实验室检查最终确诊为Sweet综合征。结果：给予糖皮质激素联合免疫抑制剂治疗后，患者症状显著缓解。结论：针对合并血液系统疾病且临床表现疑似眼眶蜂窝织炎患者，应高度警惕Sweet综合征的可能，及时行病理学检查并给予有效的治疗手段，以避免不良预后。

Abstract: Objective: To explore the clinical manifestations and diagnostic key points of severe orbital cellulitis-like Sweet syndrome, analyze the disease progression and causes of misdiagnosis, and summarize treatment strategies. Methods: A retrospective analysis was conducted on the clinical data of a 75-year-old male patient. The patient initially presented with severe swelling and congestion of the skin and soft tissues of the left upper eyelid, accompanied by fever, and was preliminarily misdiagnosed as bacterial orbital cellulitis. Antibiotic therapy proved ineffective, and the condition deteriorated rapidly. The patient had a prior history of myelofibrosis. Sweet syndrome was ultimately confirmed through skin lesion biopsy and laboratory investigations. Results: Following treatment with glucocorticoids combined with tripterygium glycosides, the patient’s symptoms improved markedly. Conclusion: In patients with underlying hematologic disorders who present with clinical features suggestive of orbital cellulitis, a high index of suspicion for Sweet syndrome should be maintained. Prompt histopathological examination and timely effective therapeutic intervention are essential to prevent adverse outcomes.