Kailasanathan Anusha, Anderson David F
Southampton University Hospitals Trust, Southampton, Hampshire, UK.
Cornea. 2007 Jun;26(5):643-4. doi: 10.1097/ICO.0b013e3180439c0c.
To report a novel case of infectious crystalline keratopathy after penetrating keratoplasty caused by Gemella haemolysans.
Observational case report. Patient notes and literature review.
A 51-year-old woman presented with the clinical picture of infectious crystalline keratopathy 18 months after a second penetrating keratoplasty was performed for corneal decompensation secondary to recurrent herpes simplex infection. Corneal biopsy yielded a heavy growth of G. haemolysans. Initial treatment was made up of frequent topical vancomycin 0.5% and was later changed to topical cefuroxime 5% and ofloxacin 0.3%. Snellen visual acuity after complete resolution of the keratitis was 6/60 as a result of a residual corneal scar.
Gemella haemolysans may be an etiologic agent in infectious crystalline keratopathy. A corneal biopsy may be diagnostic but may also promote healing by allowing direct access of antibiotics to deep-seated infected tissue and by altering the growth environment of the organism.
报告1例由溶血孪生球菌引起的穿透性角膜移植术后感染性结晶性角膜病变的新病例。
观察性病例报告。查阅患者病历并进行文献回顾。
一名51岁女性,因复发性单纯疱疹感染继发角膜失代偿接受二次穿透性角膜移植术后18个月,出现感染性结晶性角膜病变的临床表现。角膜活检显示溶血孪生球菌大量生长。初始治疗为频繁局部应用0.5%万古霉素,后改为局部应用5%头孢呋辛和0.3%氧氟沙星。由于角膜瘢痕残留,角膜炎完全消退后Snellen视力为6/60。
溶血孪生球菌可能是感染性结晶性角膜病变的病原体。角膜活检可能具有诊断价值,还可通过使抗生素直接作用于深部感染组织以及改变病原体的生长环境来促进愈合。