Chen Fred K, Chen Simon D M, Tay-Kearney Mei-Ling
Clin Exp Ophthalmol. 2007 May-Jun;35(4):382-5. doi: 10.1111/j.1442-9071.2007.01493.x.
Scedosporium apiospermum is an increasingly recognized cause of endogenous fungal endophthalmitis in immunocompromised patients. The authors describe two patients with endogenous S. apiospermum endophthalmitis treated with intravitreal and systemic voriconazole. Despite a prolonged course of systemic antifungal treatment, both patients subsequently required enucleation for intractable ocular pain due to secondary scleritis. Histological examination of the globes demonstrated the presence of fungal hyphae. Endogenous S. apiospermum endophthalmitis need to be considered in the differential diagnosis of necrotizing retinitis. Despite its efficacy in suppressing disseminated S. apiospermum infection, voriconazole may be ineffective in the treatment of endogenous S. apiospermum endophthalmitis especially if treatment is delayed.
尖端赛多孢是免疫功能低下患者内源性真菌性眼内炎日益被认识的病因。作者描述了两名接受玻璃体内及全身伏立康唑治疗的内源性尖端赛多孢眼内炎患者。尽管进行了长时间的全身抗真菌治疗，但两名患者随后均因继发性巩膜炎导致的顽固性眼痛而需要摘除眼球。眼球的组织学检查显示存在真菌菌丝。在坏死性视网膜炎的鉴别诊断中需要考虑内源性尖端赛多孢眼内炎。尽管伏立康唑在抑制播散性尖端赛多孢感染方面有效，但它可能对内源性尖端赛多孢眼内炎的治疗无效，尤其是治疗延迟时。
