Vagefi M Reza, Kim Eleanore T, Alvarado Richard G, Duncan Jacque L, Howes Ed L, Crawford J Brooks
Department of Ophthalmology, University of California, San Francisco, California 94143-0730, USA.
Am J Ophthalmol. 2005 Feb;139(2):370-3. doi: 10.1016/j.ajo.2004.08.005.
To report a case of bilateral endogenous fungal endophthalmitis resulting from disseminated Scedosporium prolificans.
Observational case report.
A 56-year-old woman with cystic fibrosis status post dual lung transplantation on chronic immunosuppressive therapy presented with acute graft rejection. Cultures of bronchial brushings revealed S. prolificans. Three weeks after admission, the patient noted increased blurriness and a central scotoma in her right eye. Dilated fundus examination revealed profound vitritis in the right eye with hemorrhagic retinitis involving the macula. A peripheral, yellow choroidal infiltrate with overlying retinitis and localized vitritis was present in the left eye.
Intravitreal antibiotics were initiated, and vitreous cultures revealed S. prolificans. The patient ultimately succumbed to her disseminated disease. Pathologic examination of the eyes confirmed bilateral endogenous fungal endophthalmitis.
S. prolificans is an opportunistic infection resistant to standard antifungal therapy that can result in endogenous endophthalmitis in immunocompromised individuals.
报告一例由播散性多育赛多孢菌引起的双侧内源性真菌性眼内炎病例。
观察性病例报告。
一名56岁的女性，双肺移植术后患有囊性纤维化，接受慢性免疫抑制治疗，出现急性移植物排斥反应。支气管刷检培养显示有多育赛多孢菌。入院三周后，患者注意到右眼视力模糊加重，出现中心暗点。散瞳眼底检查显示右眼有严重的玻璃体炎，黄斑区有出血性视网膜病变。左眼有周边黄色脉络膜浸润，伴有视网膜病变和局限性玻璃体炎。
开始玻璃体腔内注射抗生素，玻璃体培养显示有多育赛多孢菌。患者最终死于播散性疾病。眼部病理检查证实为双侧内源性真菌性眼内炎。
多育赛多孢菌是一种对标准抗真菌治疗耐药的机会性感染菌，可导致免疫功能低下个体发生内源性眼内炎。
