Bouchard C S, Chacko B, Cupples H P, Cavanagh H D, Mathers W D
Department of Ophthalmology, Loyola University Medical Center, Maywood 60152.
Ophthalmic Surg. 1991 Feb;22(2):98-101.
Pseudallescheria boydii (P. boydii) is an uncommon ocular pathogen which previously has been identified in only 10 of 905 fungal isolates identified by the Sid Richardson Microbiology Laboratory at the Cullen Eye Institute of Baylor College of Medicine. Furthermore, only one case of postoperative P. boydii endophthalmitis and four cases of endogenous P. boydii endophthalmitis have been reported. Three of the four patients with endogenous endophthalmitis died within 4 weeks of diagnosis. We describe a second case of postoperative endophthalmitis due to this fungus. The infection was successfully eradicated following vitrectomy, corneoscleral resection, and patch graft, in addition to intraocular, topical, and oral antifungal medication. Although in vitro sensitivities are variable, P. boydii is known to be relatively resistant to amphotericin B. This points to the importance of proper cultures and sensitivities when treating cases of suspected fungal endophthalmitis. Unfortunately, the patient's eye became phthisical 6 months following the initial intervention.
波氏假阿利什菌（P. boydii）是一种不常见的眼部病原体，此前在贝勒医学院卡伦眼科研究所的西德·理查森微生物实验室鉴定的905株真菌分离物中仅发现了10株。此外，仅报告了1例术后波氏假阿利什菌性眼内炎和4例内源性波氏假阿利什菌性眼内炎。4例内源性眼内炎患者中有3例在诊断后4周内死亡。我们描述了第二例由这种真菌引起的术后眼内炎。除眼内、局部和口服抗真菌药物外，通过玻璃体切除术、角膜巩膜切除术和补片移植成功根除了感染。尽管体外敏感性存在差异，但已知波氏假阿利什菌对两性霉素B相对耐药。这表明在治疗疑似真菌性眼内炎病例时进行适当培养和药敏试验的重要性。不幸的是，在初次干预6个月后，患者的眼睛萎缩。
