Kumar Sahu Srikant, Das Sujata, Sharma Savitri, Sahu Kalyani
Cornea and Anterior Segment Service, L V Prasad Eye Institute, Bhubaneswar 751024, India.
Int J Inflam. 2012;2012:753560. doi: 10.1155/2012/753560. Epub 2011 Nov 20.
Medical and microbiology records of seventeen patients (17 eyes), diagnosed as scleritis of infectious origin were reviewed; to study clinical features, predisposing risk factors, microbiologic profile and treatment outcome of infectious scleritis. The mean patient age was 52.3 ± 19.75 years. Twelve patients (70.6%) had history of trauma/prior surgery. Isolated organisms included Staphylococcus species (spp) (n = 5), Fungus (n = 4), Nocardia spp (n = 3), two each of atypical Mycobacterium spp and Streptococcus pneumoniae and one Pseudomonas aeruginosa. Treatment included intensive topical antimicrobial in all eyes and systemic medication in 15 (88.2%) patients; surgical exploration was needed for 13 (76.5%) patients and scleral patch graft was done in four (23.5%) patients. Lesions resolved in all patients and none required evisceration. The presenting log MAR visual acuity of 1.77 ± 1.40 and improved to 0.99 ± 0.91. (P ≤ 0.039) after treatment with a mean follow up of 22.57 ± 19.53 weeks. A microbiological confirmation, appropriate medical and/or surgical intervention has a good tectonic and visual outcome.
回顾了17例(17只眼)诊断为感染性巩膜炎患者的医学和微生物学记录,以研究感染性巩膜炎的临床特征、易感危险因素、微生物谱和治疗结果。患者平均年龄为52.3±19.75岁。12例患者(70.6%)有外伤/既往手术史。分离出的病原体包括葡萄球菌属(n = 5)、真菌(n = 4)、诺卡菌属(n = 3)、非典型分枝杆菌属和肺炎链球菌各2例,以及铜绿假单胞菌1例。所有患眼均进行了强化局部抗菌治疗,15例(88.2%)患者接受了全身用药;13例(76.5%)患者需要进行手术探查,4例(23.5%)患者进行了巩膜补片移植。所有患者的病变均得到缓解,无一例需要眼球摘除。治疗前呈现的对数最小分辨角视力为1.77±1.40,平均随访22.57±19.53周后改善至0.99±0.91(P≤0.039)。微生物学确诊、适当的药物和/或手术干预具有良好的结构和视觉效果。