念珠菌性角膜炎的临床特征与转归
Clinical characteristics and outcome of Candida keratitis.
作者信息
Sun Regina L, Jones Dan B, Wilhelmus Kirk R
机构信息
Sid W. Richardson Ocular Microbiology Laboratory, Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas 77030, USA.
出版信息
Am J Ophthalmol. 2007 Jun;143(6):1043-1045. doi: 10.1016/j.ajo.2007.02.016.
PURPOSE
To characterize the clinical features and therapeutic outcome of Candida keratitis.
DESIGN
Retrospective, observational case series.
METHODS
We reviewed 26 patients treated for Candida keratitis, including two with recurrent keratitis and one with bilateral infection.
RESULTS
Of 29 keratitis episodes resulting from Candida albicans (n = 20) or Candida parapsilosis (n = 9), 16 (55%) complicated chronic ocular surface disease, and nine (31%) followed previous keratoplasty. Only two were clinically suspected to have keratomycosis at initial presentation, and 21 (72%) used antibacterial therapy before corneal scrapings. Reconstructive keratoplasty occurred more often in previously grafted eyes (P = .03). Visual outcome was 20/60 or better in six (100%) medically treated eyes with good presenting visual acuity but in only five eyes (24%) with worse initial vision (P = .002).
CONCLUSIONS
Candida keratitis is an opportunistic infection of a compromised cornea that often is misdiagnosed initially and, despite antifungal therapy, occasionally requires corneal grafting.
目的
描述念珠菌性角膜炎的临床特征及治疗效果。
设计
回顾性观察病例系列。
方法
我们回顾了26例接受念珠菌性角膜炎治疗的患者，其中包括2例复发性角膜炎患者和1例双侧感染患者。
结果
在由白色念珠菌（n = 20）或近平滑念珠菌（n = 9）引起的29次角膜炎发作中，16次（55%）并发慢性眼表疾病，9次（31%）继发于先前的角膜移植术。初次就诊时临床上仅2例疑似角膜真菌病，21例（72%）在角膜刮片检查前使用了抗菌治疗。重建性角膜移植术在先前接受过移植的眼中更为常见（P = .03）。在6例（100%）初始视力良好且接受药物治疗的眼中，视力结果为20/60或更好，但在初始视力较差的眼中，只有5例（24%）达到此结果（P = .002）。
结论
念珠菌性角膜炎是角膜受损后的一种机会性感染，最初常被误诊，尽管进行了抗真菌治疗，但偶尔仍需要角膜移植。
Zotero 插件