Yildiran Sinasi Taner, Mutlu Fatih Mehmet, Saracli Mehmet Ali, Uysal Yusuf, Gonlum Ahmet, Sobaci Gungor, Sutton Deanna A
Division of Medical Mycology, Department of Microbiology and Clinical Microbiology, Gulhane Military Medical Academy and School of Medicine, Ankara, Turkey.
Med Mycol. 2006 Nov;44(7):665-9. doi: 10.1080/13693780600717161.
The first case of postoperative endophthalmitis after cataract surgery caused by Aspergillus ustus, a species that has only rarely been implicated in human disease, is described. Six weeks after cataract surgery, a 67-year-old medically controlled diabetic patient presented with uveitis, mild ciliary injection and ocular discomfort. Anterior chamber paracentesis, vitreous tap and finally complete vitrectomy with removal of the capsular bag including the intraocular lens were performed and several sets of culture yielded A. ustus. Despite vigorous systemic (itraconazole and caspofungin) and intravitreal (amphotericin B and caspofungin) antifungal therapy, the endophthalmitis did not improve. The painful eye with marked inflammation was finally enucleated. In vitro susceptibility testing of the isolate showed that it appeared resistant to amphotericin B, caspofungin, itraconazole, voriconazole, and posaconazole, and susceptible to terbinafine.
本文描述了首例由ustus曲霉引起的白内障手术后眼内炎病例，该菌种很少与人类疾病相关。白内障手术后六周，一名67岁接受药物控制的糖尿病患者出现葡萄膜炎、轻度睫状充血和眼部不适。进行了前房穿刺、玻璃体穿刺，最终进行了完全玻璃体切除术，切除包括人工晶状体的囊袋，多次培养均检出ustus曲霉。尽管进行了积极的全身（伊曲康唑和卡泊芬净）和玻璃体内（两性霉素B和卡泊芬净）抗真菌治疗，但眼内炎并未改善。最终摘除了炎症明显的患眼。对分离菌株的体外药敏试验表明，它对两性霉素B、卡泊芬净、伊曲康唑、伏立康唑和泊沙康唑耐药，对特比萘芬敏感。
