由尖端赛多孢菌引起的真菌性角膜炎：两例报告及治疗综述
Fungal keratitis caused by Scedosporium apiospermum: report of two cases and review of treatment.
作者信息
Wu Ziqiang, Ying Howard, Yiu Samuel, Irvine John, Smith Ronald
机构信息
Doheny Eye Institute, Keck School of Medicine, University of Southern California, 1450 San Pablo Street, Los Angeles, CA 90033, USA.
出版信息
Cornea. 2002 Jul;21(5):519-23. doi: 10.1097/00003226-200207000-00016.
PURPOSE
We report our experience in treating two cases of Scedosporium apiospermum keratitis and provide a review of basic scientific and clinical data regarding the treatment of this visually devastating disease.
METHOD
We present a case report and literature review.
RESULTS
A 35-year-old woman and a 73-year-old man both reported pain, redness, and a foreign body sensation in the eye after trauma. They were initially treated with antibacterials. When cultures were positive for S. apiospermum, the first patient was treated with fluconazole and amphotericin with good results. The second was treated with fluconazole and natamycin, but the infection persisted and the eye was eventually enucleated. Review of the literature showed variable responsiveness of S. apiospermum to antifungal treatment.
CONCLUSIONS
It is difficult to predict how S. apiospermum keratitis will respond to treatment, but miconazole appears to be useful in conjunction with other antifungals. Voriconazole shows promise as an effective alternative.
目的
我们报告治疗两例尖端赛多孢菌角膜炎的经验，并对有关这种致盲性疾病治疗的基础科学和临床数据进行综述。
方法
我们呈现一份病例报告及文献综述。
结果
一名35岁女性和一名73岁男性均在眼部受伤后出现疼痛、眼红及异物感。他们最初接受抗菌药物治疗。当培养结果显示尖端赛多孢菌阳性时，首例患者接受氟康唑和两性霉素治疗，效果良好。第二例患者接受氟康唑和那他霉素治疗，但感染持续存在，最终眼球被摘除。文献综述显示尖端赛多孢菌对抗真菌治疗的反应不一。
结论
难以预测尖端赛多孢菌角膜炎对治疗的反应，但咪康唑与其他抗真菌药物联合使用似乎有效。伏立康唑有望成为一种有效的替代药物。
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