Delgado C Edgar, Durán O Patricia, Neira S Orlando, Veloza G Claudia
Hospital Militar Central, Bogotá, Colombia.
Rev Chilena Infectol. 2008 Aug;25(4):295-300. Epub 2008 Aug 13.
We report the case of a female patient, 56-year-old housewife, for the first time user of last generation contact lenses: Lotrafilcon B, which presented a severe corneal ulcer by Pseudomonas aeruginosa in hev left eye and subsequently required keratoplasty. Initially she reported pain and arrived at the emergency department with red eye, corneal central ulcer of three days of evolution and hypopion. Initially she received topic mydriatic drugs and prednisolone at 1%. At the next day the ophthalmologycal exam showed hypopion at 5% and a central severe ulcer greater than 3 mm in diameter with sharp edges and mucopurulent secretion. The treatment was changed to moxifloxacin and natamycin. The microbiological analysis performed in two laboratories yielded Aspergillus sp. and Pseudomonas aeruginosa sensitive to ciprofloxacin, tobramycin, gentamicin and moxifloxacin. The presence of Aspergillus was interpreted as a pollution lens case and likely colonization of the cornea because of the patient good performance. After four months although improving she required corneal transplantation. Photographic documentation of the case under illumination with slit lamp is presented.
我们报告了一例56岁的家庭主妇女性患者，她首次使用了新一代隐形眼镜：Lotrafilcon B，其左眼因铜绿假单胞菌感染出现严重角膜溃疡，随后需要进行角膜移植。最初，她诉说疼痛，因眼红、角膜中央溃疡已发展三天且有前房积脓而前往急诊科。最初她接受了局部散瞳药物和1%的泼尼松龙治疗。第二天眼科检查显示前房积脓占5%，中央有一个直径大于3毫米的严重溃疡，边缘锐利且有黏液脓性分泌物。治疗改为莫西沙星和那他霉素。在两个实验室进行的微生物分析结果显示为曲霉属，以及对环丙沙星、妥布霉素、庆大霉素和莫西沙星敏感的铜绿假单胞菌。曲霉的存在被解释为镜片污染病例，且由于患者情况良好，可能是角膜定植。四个月后，尽管病情有所改善，但她仍需要进行角膜移植。本文展示了该病例在裂隙灯照明下的照片记录。
