Division of Ophthalmology, Department of Visual Sciences, Nihon University School of Medicine, Ohyaguchi-kamimachi Itabashi-ku, Tokyo, Japan.
Cornea. 2011 Jul;30(7):784-6. doi: 10.1097/ICO.0b013e31820129fd.
To investigate the demography, causative bacteria, and clinical findings in 3 patients with expulsive hemorrhage.
The clinical records of 3 patients (3 eyes), who developed expulsive hemorrhage because of infectious keratitis and were treated at our hospital between December 2006 and January 2008, were investigated retrospectively.
Three women, older than 70 years, with physical and mental disabilities because of senile dementia were studied. Two were residents at a nursing home. Basic corneal disorders included bullous keratopathy, cicatricial syphilitic keratitis, and traumatic keratitis because of a foreign body. All patients developed expulsive hemorrhage. Two patients underwent enucleation, and 1 underwent bulbar exenteration with sclerocorneal patch for expulsive hemorrhage. Bacterial culture in these cases isolated either Capnocytophaga sp. and penicillin-intermediate resistant Streptococcus pneumoniae or methicillin-resistant Staphylococcus aureus.
This is the first recorded case of Capnocytophaga keratitis in Japan. Patients with dementia may develop severe ocular complications after infectious keratitis because of their inability to communicate.
调查 3 例因感染性角膜炎引起的暴发性出血患者的人口统计学、病原菌和临床发现。
回顾性研究了 2006 年 12 月至 2008 年 1 月期间我院收治的 3 例（3 只眼）因感染性角膜炎导致暴发性出血的患者的临床记录。
3 名女性，年龄均大于 70 岁，因老年痴呆而存在身心障碍。其中 2 人为养老院居民。基本的角膜病变包括大疱性角膜病变、瘢痕性梅毒性角膜炎和异物性外伤性角膜炎。所有患者均发生暴发性出血。2 例患者行眼球摘除术，1 例患者因暴发性出血行眼内容剜除联合巩膜角膜修补术。这些病例的细菌培养分离出嗜二氧化碳噬纤维菌和耐青霉素中间的肺炎链球菌或耐甲氧西林金黄色葡萄球菌。
这是日本首例嗜二氧化碳噬纤维菌角膜炎的报道。痴呆患者可能因无法沟通而在感染性角膜炎后发生严重的眼部并发症。
