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角膜内皮移植术后龟分枝杆菌界面感染

Mycobacterium chelonae interface infection after endokeratoplasty.

作者信息

Busin Massimo, Ponzin Diego, Arffa Robert C

机构信息

Casa di Cura Villa Serena, Forlì, Italy.

出版信息

Am J Ophthalmol. 2003 Mar;135(3):393-5. doi: 10.1016/s0002-9394(02)01954-2.

Abstract

PURPOSE

To report a case of interface infection by Mycobacterium chelonae in a patient who underwent endokeratoplasty.

DESIGN

Interventional case report.

SETTING

Clinical practice.

METHODS

Two weeks after endokeratoplasty, a 74-year-old woman developed multiple enlarging interface infiltrates in her right eye. Cultures performed on the preservation medium grew Mycobacterium chelonae. Penetrating keratoplasty (PK) surgery was performed after failure of conservative antibiotic therapy, including topical and systemic clarithromycin.

RESULTS

Five months after PK surgery, the graft was clear and no signs of extraocular or intraocular inflammation were present. Cultures taken from the corneal interface at the time of PK surgery confirmed the presence of M. chelonae. Acid-fast bacilli were seen in the excised corneal button.

CONCLUSIONS

M. chelonae should be ruled out as a possible etiologic agent when postoperative infection of the corneal interface occurs. Surgical intervention can lead to eradication of the infection when conservative treatment fails.

摘要

目的

报告1例接受角膜内皮移植术的患者发生龟分枝杆菌界面感染的病例。

设计

介入性病例报告。

背景

临床实践。

方法

角膜内皮移植术后两周,一名74岁女性右眼出现多个不断增大的界面浸润灶。在保存培养基上培养出龟分枝杆菌。在包括局部和全身使用克拉霉素的保守抗生素治疗失败后,进行了穿透性角膜移植术(PK)。

结果

PK手术后5个月,移植片透明,无眼外或眼内炎症迹象。PK手术时取自角膜界面的培养物证实存在龟分枝杆菌。在切除的角膜植片中可见抗酸杆菌。

结论

当发生角膜界面术后感染时,应排除龟分枝杆菌作为可能的病原体。保守治疗失败时,手术干预可根除感染。

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