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隐形眼镜佩戴继发双侧同时性感染性角膜炎:一例罕见病原体所致的特殊病例报告

Bilateral simultaneous infectious keratitis secondary to contact lens wear: an unusual case report with rare organisms.

作者信息

Ali Nadir Ali Mohamed, Reddy Sagili Chandrasekhara

机构信息

Department of Ophthalmology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

出版信息

Eye Contact Lens. 2007 Nov;33(6 Pt 1):338-40. doi: 10.1097/ICL.0b013e3180421be3.

Abstract

PURPOSE

To report an unusual case of bilateral simultaneous hypopyon corneal ulcer in a contact lens wearer caused by polymicrobial infection with rare organisms.

METHODS

A case report of a 21-year-old soft contact lens wearer, who visited the emergency department with a 3-day history of pain, redness, decreased vision, photophobia, and tearing in both eyes. Examination showed a central corneal ulcer with hypopyon in both eyes. The cultures from corneal scrapings of both eyes, the contact lenses, and the contact lens solution showed heavy growth of Pseudomonas aeruginosa, Alkaligenes species, and Flavobacterium meningosepticum.

RESULTS

The corneal ulcers healed completely with aggressive antibiotic treatment for 4 weeks. The best-corrected visual acuity after 6 months of follow-up was 20/400 in the right eye and 20/60 in the left eye.

CONCLUSIONS

The possibility of infectious keratitis should be kept in mind for an acute red eye in contact lens wearers, and appropriate initial management is essential for a successful outcome. It is believed that this is the first report of Flavobacterium meningosepticum as a causative organism in contact lens-related keratitis.

摘要

目的

报告一例由罕见微生物的多微生物感染引起的隐形眼镜佩戴者双侧同时发生前房积脓性角膜溃疡的不寻常病例。

方法

一名21岁软性隐形眼镜佩戴者的病例报告,该患者因双眼疼痛、发红、视力下降、畏光和流泪3天而到急诊科就诊。检查发现双眼中央角膜溃疡伴前房积脓。双眼角膜刮片、隐形眼镜及隐形眼镜护理液的培养显示铜绿假单胞菌、产碱杆菌属和脑膜炎败血黄杆菌大量生长。

结果

经过4周的积极抗生素治疗,角膜溃疡完全愈合。随访6个月后,右眼最佳矫正视力为20/400,左眼为20/60。

结论

对于隐形眼镜佩戴者出现的急性红眼,应考虑感染性角膜炎的可能性,适当的初始处理对于取得成功的结果至关重要。据信,这是脑膜炎败血黄杆菌作为隐形眼镜相关性角膜炎致病原的首次报告。

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