Chen Jiunn-Liang, Wang Cheng-Chiang, Sheu Shwu-Jiuan, Yeh Tzy-Ing
Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Kaohsiung J Med Sci. 2005 Jun;21(6):286-90. doi: 10.1016/S1607-551X(09)70203-7.
A 30-year-old healthy female presented with a 1-year history of chronic mucous discharge, tearing, and irritation in the left eye. Slit-lamp examination revealed severe papillary and follicular reaction surrounding a movable subconjunctival mass on the left upper tarsal conjunctiva. Incision and curettage were performed to establish the diagnosis. Multiple peculiar black mulberry nodules were obtained. The clumps of septate hyphae seen with periodic acid-Schiff stain were characteristic of fungus ball (aspergilloma). The patient's symptoms improved significantly after surgery without any antifungal therapy. Although rarely reported, aspergillus is a common fungus in the conjunctiva that may seed into the subconjunctiva. We present this case to remind ophthalmologists of such a rare cause of recalcitrant conjunctival inflammation in immunocompetent patients.
一名30岁健康女性，左眼有1年慢性黏液性分泌物、流泪及刺激感病史。裂隙灯检查发现左上睑结膜有一个可移动的结膜下肿物，其周围有严重的乳头和滤泡反应。进行了切开刮除术以明确诊断。获取了多个特殊的黑色桑葚样结节。高碘酸-希夫染色可见的分隔菌丝团块是真菌球（曲菌球）的特征。患者术后症状显著改善，未接受任何抗真菌治疗。尽管报道较少，但曲霉菌是结膜中常见的真菌，可能播散至结膜下。我们报告此病例以提醒眼科医生，在免疫功能正常的患者中，这是一种导致顽固性结膜炎症的罕见病因。
