Kim's Eye Hospital, Department of Ophthalmology, Konyang University, Seoul, Korea.
J Cataract Refract Surg. 2009 Dec;35(12):2157-60. doi: 10.1016/j.jcrs.2009.06.035.
A 40-year-old man developed pain, decreased vision, and a corneal infiltrate 10 days after laser-assisted subepithelial keratectomy. Treatment with conventional topical and systemic antibiotic agents did not improve the symptoms. Approximately 2 weeks after surgery, the patient was referred to Kim's Eye Hospital, presenting with counting fingers visual acuity, moderate anterior chamber reaction, and multifocal stromal infiltrates in the left eye. The corneal infiltrate findings were suggestive of fungal keratitis, and corneal smears were positive for septate fungal hyphae. Treatment with topical amphotericin B was initiated, but there was little response. After mycology culture and molecular analysis identified Epidermophyton floccosum as the infectious organism, topical natamycin was added and the infiltrate gradually resolved. Three weeks after treatment with natamycin, the corrected visual acuity was 20/25. Treatment with topical natamycin was effective against Epidermophyton keratitis.
一位 40 岁男性在激光辅助上皮下角膜切除术 10 天后出现疼痛、视力下降和角膜浸润。尽管使用了常规的局部和全身抗生素治疗，但症状并未改善。术后约 2 周，患者因左眼视力指数、中度前房反应和多灶性基质浸润被转诊至金眼科医院。角膜浸润的表现提示真菌性角膜炎，角膜刮片阳性可见有分隔的真菌菌丝。开始使用局部两性霉素 B 治疗，但反应不大。在进行真菌培养和分子分析后，鉴定出感染病原体为絮状表皮癣菌，随后加用局部那他霉素，浸润逐渐消退。在使用那他霉素治疗 3 周后，矫正视力为 20/25。局部使用那他霉素治疗絮状表皮癣菌角膜炎有效。
