Yang Kai-Shiang, Lin Hsin-Chiung, Ma David H K, Chen Hung-Chi, Tan Hsin-Yuan, Huang Samuel C M, Lin Ken-Kuo, Hsiao Ching-Hsi
Department of Ophthalmology, Chang Gung Memorial Hospital, Taipei, Taiwan, Republic of China.
Cornea. 2006 Jul;25(6):701-4. doi: 10.1097/01.ico.0000208816.02120.4b.
To report the clinical course, treatments, antibiotic sensitivities, and visual outcomes for eyes with ulcerative keratitis caused by Haemophlilus influenzae.
The medical records of 10 patients with culture-proven H. influenzae-associated corneal ulcer in a tertiary referral center in a 5-year period (1998-2003) were retrospectively reviewed.
The median age was 61 years (range, 2-83 years). The mean follow-up time was 9.4 months (range, 2-31 months). Risk factors such as previous surgeries (5), herpes simplex keratitis (2), leukoma adherens with calcification (1), and exposure keratitis (1) were identified in 9 patients. In vitro testing of the H. influenzae isolates showed that 6 of 10 were resistant to ampicillin; all were sensitive to amoxicillin/clavulanic acid, ceftriaxone, and cefuroxime. All cases responded well to medical antibiotic treatment. Final best spectacle-corrected visual acuity ranged from no light perception to 20/30.
H. influenzae is a rare cause of corneal ulceration. Predisposing factors for infection are usually present. Accurate diagnosis and treatment may preserve ocular integrity and visual acuity.
报告由流感嗜血杆菌引起的溃疡性角膜炎患者的临床病程、治疗方法、抗生素敏感性及视力预后。
回顾性分析一家三级转诊中心在5年期间（1998 - 2003年）10例经培养证实为流感嗜血杆菌相关性角膜溃疡患者的病历。
患者年龄中位数为61岁（范围2 - 83岁）。平均随访时间为9.4个月（范围2 - 31个月）。9例患者存在如既往手术史（5例）、单纯疱疹性角膜炎（2例）、粘连性角膜白斑伴钙化（1例）及暴露性角膜炎（1例）等危险因素。流感嗜血杆菌分离株的体外试验显示，10株中有6株对氨苄西林耐药；所有菌株对阿莫西林/克拉维酸、头孢曲松和头孢呋辛敏感。所有病例对抗生素药物治疗反应良好。最终最佳矫正视力范围从无光感到20/30。
流感嗜血杆菌是角膜溃疡的罕见病因。通常存在感染的易感因素。准确的诊断和治疗可维持眼的完整性和视力。
