Sherman Amanda, Daniels Joshua B, Wilkie David A, Lutz Elizabeth
Department of Clinical Sciences, The Ohio State University, 601 Vernon Tharp Street, Columbus, OH 43210, USA.
Vet Ophthalmol. 2013 Sep;16(5):386-91. doi: 10.1111/vop.12001. Epub 2012 Nov 4.
A 5-year-old spayed female diabetic mixed-breed dog underwent phacoemulsification and intraocular lens implantation to correct bilateral hypermature cataracts. Two months postsurgery, the patient presented with ulcerative keratitis and multifocal stromal abscessation OD, which was controlled, but never resolved, with topical fluoroquinolone therapy. The patient re-presented 2 months later with a new, raised, white gritty corneal opacity associated with hyperemia, chemosis, and blepharospasm OD. Cytology of the right cornea revealed filamentous bacteria, suggestive of Actinomyces spp. Actinomyces bowdenii was subsequently isolated in pure culture and identified via 16s rDNA sequencing. Actinomyces bowdenii has never before been described as a cause of ocular infection. An immunosuppressed corneal environment likely contributed to this opportunistic Actinomycosis. The infection was not controlled with fluoroquinolone therapy, and the isolate, in vitro, was resistant to three fluoroquinolones (ciprofloxacin, ofloxacin, and levofloxacin), which also has not been previously reported for this species of Actinomyces. A superficial keratectomy with conjunctival graft was employed to successfully manage the infection.
一只5岁已绝育的雌性糖尿病混血犬接受了超声乳化白内障吸除术和人工晶状体植入术,以矫正双侧超成熟白内障。术后两个月,该犬右眼出现溃疡性角膜炎和多灶性基质脓肿,经局部氟喹诺酮治疗得到控制,但未完全消退。两个月后,该犬右眼再次出现一个新的、隆起的、白色沙粒状角膜混浊,伴有充血、结膜水肿和眼睑痉挛。右眼角膜细胞学检查发现丝状细菌,提示放线菌属。随后从纯培养物中分离出鲍登氏放线菌,并通过16s rDNA测序进行鉴定。鲍登氏放线菌此前从未被描述为眼部感染的病因。免疫抑制的角膜环境可能促成了这种机会性放线菌病。氟喹诺酮治疗未能控制感染,且该分离株在体外对三种氟喹诺酮(环丙沙星、氧氟沙星和左氧氟沙星)耐药,这在该种放线菌中也未曾有过报道。采用浅表角膜切除术联合结膜移植成功控制了感染。