Cornea Service, Wills Eye Institute, Thomas Jefferson University, Philadelphia, PA, USA.
Cornea. 2010 Apr;29(4):449-52. doi: 10.1097/ICO.0b013e3181af3954.
To report the first case of fungal keratitis caused by presumed Carpoligna species.
A 37-year-old gardener sustained a full-thickness, stellate corneal laceration while cutting wood outdoors with a circular saw. Two months after surgical repair, he developed a severe infectious keratitis with descemetocoele at the apex of the original stellate laceration.
Culture results confirmed fungal elements without evidence of bacteria. Oral and topical voriconazole were initiated. Due to compliance and cost issues, voriconazole was replaced with natamycin 5% prior to discharge from hospital. The patient improved and healed without perforation. The patient was left with a central stromal scar. DNA extraction from the fungal colony allowed PCR amplification of the 28s ribosomal RNA region of the fungus that led to the diagnosis of Carpoligna pleurothecii. Corticosteroids were never used during the patient's treatment.
This is the first reported case of infectious keratitis caused by presumed Carpoligna species. The treatment for Carpoligna pleurothecii keratitis includes voriconazole, natamycin, and possibly amphotericin B.
报告首例疑似 Carpoligna 种真菌性角膜炎病例。
一名 37 岁的园丁在户外使用圆锯切割木材时，角膜发生全层、星状撕裂。在手术修复两个月后，他发生了严重的感染性角膜炎，在原来星状撕裂的顶点处出现了后弹力层膨出。
培养结果证实了真菌的存在，而没有细菌的证据。开始口服和局部伏立康唑治疗。由于依从性和费用问题，在出院前，伏立康唑被那他霉素 5%取代。患者在没有穿孔的情况下得到改善并愈合。患者留下中央基质瘢痕。从真菌菌落中提取 DNA 进行聚合酶链反应扩增真菌的 28s 核糖体 RNA 区域，从而诊断为 Pleurothecii。在患者的治疗过程中从未使用过皮质类固醇。
这是首例报道的疑似 Carpoligna 种引起的感染性角膜炎病例。治疗 Pleurothecii 角结膜炎包括伏立康唑、那他霉素和可能的两性霉素 B。
