Pérez-Santonja J J, Campos-Mollo E, Fuentes-Campos E, Samper-Giménez J, Alió J L
Department of Ophthalmology, Hospital Virgen de los Lirios, Alcoy, Spain.
Eur J Ophthalmol. 2007 May-Jun;17(3):445-7. doi: 10.1177/112067210701700331.
To report a case of unusual chronic endophthalmitis by Actinomyces neuii subspecies anitratus.
A 75-year-old man underwent uneventful phacoemulsification with implantation of a foldable posterior chamber intraocular lens in his right eye. Four weeks after surgery, a chronic post-operative endophthalmitis characterized by anterior chamber and vitreous cellular debris developed in this eye. Cultures were positive, and A neuii subspecies anitratus was identified by polymerase chain reaction and subsequent rRNA sequence analysis. Immediate treatment included intravitreal and intensive topical antibiotics along with oral ciprofloxacin.
The condition improved rapidly, and 6 months after surgery the patient was asymptomatic, the best spectacle-corrected visual acuity was 20/22, and the anterior chamber was quiet.
A neuii subspecies anitratus should be considered in the differential diagnosis of chronic endophthalmitis after cataract surgery. Polymerase chain reaction and subsequent RNA typing were useful in detecting the causative organism, and intravitreal antibiotics were successful.
报告1例由纽氏放线菌无硝亚种引起的罕见慢性眼内炎病例。
一名75岁男性右眼顺利接受了超声乳化白内障吸除术并植入可折叠后房型人工晶状体。术后4周，该眼发生了以眼前房和玻璃体细胞碎屑为特征的慢性术后眼内炎。培养结果呈阳性，通过聚合酶链反应及随后的rRNA序列分析鉴定为纽氏放线菌无硝亚种。立即进行的治疗包括玻璃体内注射和强化局部应用抗生素以及口服环丙沙星。
病情迅速改善，术后6个月患者无症状，最佳矫正视力为20/22，前房平静。
在白内障手术后慢性眼内炎的鉴别诊断中应考虑纽氏放线菌无硝亚种。聚合酶链反应及随后的RNA分型有助于检测病原体，玻璃体内注射抗生素治疗成功。
