Cheng Huan-Huan, Ding Yong, Wu Min, Tang Cui-Cui, Zhang Ri-Jia, Lin Xiao-Feng, Xu Jin-Tang
Department of Ophthalmology, the First Affiliated Hospital of Jinan University, Guangzhou 510630, Guangdong Province, China.
Int J Ophthalmol. 2011;4(5):567-71. doi: 10.3980/j.issn.2222-3959.2011.05.20. Epub 2011 Oct 18.
Endogenous aspergillus endophthalmitis(EAE) after kidney transplant is a rare but important clinical problem due to potentially devastating consequences. Early diagnosis of EAE, timely removal of affected vitreous by vitrectomy, proper anti-fungal treatment, all contributed to the successful control of the disease. Therapeutic success of EAE in post-transplant patients depends largely on prompt diagnosis. Definite diagnosis of EAE is based on positive culture results of vitreous specimen, while fundoscopy and B scan ultrasound may aid early diagnosis. In terms of anti-fungal medicine, amphotericin B has long been the first choice, but its systemic applicaiton has severe adverse reactions, especially for patients with impaired renal function. Herein, we report the treatment modality of EAE after kidney transplant with vitrectomy, systemic administration of micafungin plus voriconazole, topical application of fluconazol and amphotercin B.
肾移植后发生的内源性曲霉菌性眼内炎（EAE）虽罕见但却是一个重要的临床问题，因其可能产生严重后果。EAE的早期诊断、通过玻璃体切割术及时清除受感染的玻璃体、适当的抗真菌治疗，均有助于成功控制该病。移植后患者EAE的治疗成功很大程度上取决于及时诊断。EAE的确切诊断基于玻璃体标本的阳性培养结果，而眼底镜检查和B超扫描有助于早期诊断。在抗真菌药物方面，两性霉素B长期以来一直是首选，但全身应用有严重不良反应，尤其是对肾功能受损的患者。在此，我们报告肾移植后EAE采用玻璃体切割术、米卡芬净联合伏立康唑全身给药、氟康唑和两性霉素B局部应用的治疗方式。
