微孢子虫性基质性角膜炎的延迟诊断：不寻常的韦塞利环表现及抗棘阿米巴药物的部分治疗
Delayed diagnosis of microsporidial stromal keratitis: unusual Wessely ring presentation and partial treatment with medications against Acanthamoeba.
作者信息
Thomas Karin E, Purcell Tracy L, Tanzer David J, Schanzlin David J
机构信息
Department of Ophthalmology, UCSD, La Jolla, California, USA.
出版信息
BMJ Case Rep. 2011 Feb 24;2011:bcr0820103233. doi: 10.1136/bcr.08.2010.3233.
Abstract
The authors report a case of an immunocompetent 38-year-old male who presented with an indolent keratitis that eluded diagnosis after multiple cultures taken over 9 months. He was started initially on medications against Acanthamoeba, after presenting with a nearly complete corneal ring 2 months after trauma. These medications likely partially treated his condition, thereby making laboratory diagnosis more difficult. He was identified as having Encephalitozoon hellum by PCR. The patient subsequently underwent cornea transplant after a full course of medical treatment and recovered best-corrected visual acuity of 20/20.
摘要
作者报告了一例38岁免疫功能正常的男性病例，该患者患有慢性角膜炎，在9个月内多次培养后仍未确诊。他在受伤2个月后出现几乎完整的角膜环，最初开始使用抗棘阿米巴药物治疗。这些药物可能部分缓解了他的病情，从而使实验室诊断更加困难。通过聚合酶链反应（PCR）确定他感染了微小隐孢子虫。患者在接受了一个完整疗程的药物治疗后，随后接受了角膜移植手术，并恢复到了20/20的最佳矫正视力。
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