Modi Dimple, Pyatetsky Dmitry, Edward Deepak P, Ulanski Lawrence J, Pursell Kenneth J, Tessler Howard H, Goldstein Debra A
Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, UIC Eye Center, Chicago, Illinois 60612, USA.
Retina. 2007 Oct;27(8):1148-51. doi: 10.1097/IAE.0b013e318030e622.
Nontuberculous mycobacterial (NTM) infections are becoming an increasingly important complication in ophthalmology, particularly among immunocompromised patients. We report a case of NTM in a 66-year-old male immunosuppressed after cardiac transplantation. Chronic granulomatous iridocyclitis progressed to purulent endophthalmitis despite intraocular and systemic antimicrobial therapy. Direct immunoflourescent staining of the vitrectomy specimen revealed acid-fast bacilli. Biopsies of nodular skin lesions revealed non-caseating granulomas with acid-fast bacilli. Cultures of skin and eye biopsies yielded Mycobacterium haemophilum. Despite aggressive combination antimicrobial therapy, the eye was eventually enucleated. Resolution of systemic infection occurred with the addition of granulocyte macrophage-colony stimulating factor. This is the first reported case of M. haemophilum endophthalmitis.
非结核分枝杆菌（NTM）感染在眼科正成为一种日益重要的并发症，尤其是在免疫功能低下的患者中。我们报告一例心脏移植术后免疫抑制的66岁男性发生NTM感染的病例。尽管进行了眼内和全身抗菌治疗，慢性肉芽肿性虹膜睫状体炎仍进展为脓性眼内炎。玻璃体切除标本的直接免疫荧光染色显示抗酸杆菌。结节性皮肤病变活检显示有含抗酸杆菌的非干酪样肉芽肿。皮肤和眼部活检组织培养分离出嗜血性分枝杆菌。尽管积极联合抗菌治疗，患眼最终还是被摘除。加用粒细胞巨噬细胞集落刺激因子后全身感染得到缓解。这是首例关于嗜血性分枝杆菌性眼内炎的报道病例。
