Uveitis Clinic, University of Buenos Aires , Buenos Aires , Argentina .
Ocul Immunol Inflamm. 2013 Dec;21(6):491-4. doi: 10.3109/09273948.2013.824104. Epub 2013 Aug 26.
Case description of a 34 year old woman with chronic granulomatous anterior uveitis following implantation of a phakic anterior chamber intraocular lens (IOL). Aqueous humor was processed for bacterial, fungal culture, and PCR analysis.
PCR for 16S ribosomal RNA universal primers was positive and Southern-blot for Propionibacterium spp was negative. Panfungal PCR was negative. Growth of a pigmented yellow colony was detected on Lowenstein-Jensen medium. The isolate was subsequently identified as Mycobacterium gordonae. The patient was treated for atypical mycobacteria as well as an intracameral injection of moxifloxacin, with resolution of inflammation and improvement in visual acuity.
This is the first reported case of Mycobacterium gordonae chronic postoperative endophthalmitis, and of chronic endophthalmitis following phakic IOL surgery. PCR and cultures were invaluable in making the diagnosis.
报告了 1 例 34 岁女性患者,在植入前房房水型有晶状体眼人工晶状体(IOL)后发生慢性肉芽肿性前葡萄膜炎。对房水进行了细菌、真菌培养和 PCR 分析。
16S 核糖体 RNA 通用引物的 PCR 为阳性,而分枝杆菌属的 Southern 印迹为阴性。全真菌 PCR 为阴性。在 Lowenstein-Jensen 培养基上检测到一个着色的黄色菌落。随后鉴定该分离株为戈登分枝杆菌。患者接受了非典型分枝杆菌治疗以及玻璃体内注射莫西沙星,炎症得到缓解,视力得到改善。
这是首例报道的戈登分枝杆菌慢性术后眼内炎病例,也是有晶状体眼 IOL 手术后慢性眼内炎的病例。PCR 和培养对诊断具有重要价值。