Eye Hospital of Wenzhou Medical College, Wenzhou, Zhejiang, China.
Mycopathologia. 2013 Dec;176(5-6):451-6. doi: 10.1007/s11046-013-9694-4. Epub 2013 Aug 15.
We report two posttraumatic fungal endophthalmitis cases with anterior and entire segment involvement caused, respectively, by Candida albicans and Aspergillus fumigatus. The anterior endophthalmitis induced by C. albicans presented multifocal lesions with hyphael structures in anterior chamber, but without involvement of posterior vitreous. The pan-endophthalmitis caused by A. fumigatus displayed significant hypopyon and vitritis. Treatment strategies are anterior chamber cleaning for anterior endophthalmitis and vitrectomy for pan-endophthalmitis, excepting systemic and topical antifungal drug applications including intravitreal injection for both types of endophthalmitis. There is a much better outcome in the case with anterior segment involvement than that with entire segment involvement. This case report provides evidence that the different types of posttraumatic fungal endophthalmitis related to different fungal infections indeed existed and should be managed with different strategies.
我们报告了两例由白色念珠菌和烟曲霉引起的创伤后真菌性眼内炎病例,分别累及眼前段和全眼球。白色念珠菌引起的眼前段眼内炎在前房呈现多灶性病变,伴有真菌丝结构,但不伴有玻璃体后段受累。烟曲霉引起的全眼球眼内炎则表现出明显的前房积脓和玻璃体炎症。治疗策略包括对眼前段眼内炎行前房冲洗,对全眼球眼内炎行玻璃体切割术,同时全身和局部应用抗真菌药物,包括两种类型的眼内炎均行玻璃体腔注射。仅累及眼前段的病例的预后明显好于累及全眼球的病例。本病例报告提供了证据,表明不同类型的创伤后真菌性眼内炎与不同的真菌感染确实存在,应采用不同的策略进行治疗。