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伪装成手术诱发坏死性巩膜炎的真菌性巩膜炎:一例报告

Fungal scleritis masquerading as surgically induced necrotizing scleritis: a case report.

作者信息

Sahu Srikant Kumar, Das Sujata, Sahani Debabrata, Sharma Savitri

机构信息

Cornea and Anterior Segment Service L V Prasad Eye Institute, Bhubaneswar, Orissa 751 024, India.

出版信息

J Med Case Rep. 2013 Dec 30;7:288. doi: 10.1186/1752-1947-7-288.

Abstract

INTRODUCTION

The object of this case is to report the clinical findings, microbiological findings and management of a case of fungal scleritis following cataract surgery, which mimicked surgically induced necrotizing scleritis.

CASE PRESENTATION

A 72-year-old Asian (Indian) man presented with scleritis following cataract surgery at another facility. He had been treated elsewhere for suspected scleritis, primarily with steroids followed by empiric antibiotic and antifungal agents. At our institute he underwent a complete microbiological workup and a scleral patch graft. The scleral scraping revealed fungal filaments. He was treated postoperatively with topical and systemic antifungal agent along with topical cyclosporine. The follow-up examination at 5 months revealed that the scleral patch graft was successful in maintaining the integrity of his globe and restoring partial vision.

CONCLUSIONS

Fungal scleritis may mimic surgically induced necrotizing scleritis. Early diagnosis and prompt management can prevent progression of the disease and further devastating complications.

摘要

引言

本病例报告旨在阐述一例白内障术后真菌性巩膜炎的临床发现、微生物学检查结果及治疗情况,该病例曾被误诊为手术诱发的坏死性巩膜炎。

病例介绍

一名72岁的亚洲(印度)男性,在另一家医疗机构接受白内障手术后出现巩膜炎。他曾在其他地方接受过疑似巩膜炎的治疗,主要使用了类固醇,随后使用了经验性抗生素和抗真菌药物。在我们研究所,他接受了全面的微生物学检查并进行了巩膜补片移植。巩膜刮片显示有真菌丝。术后他接受了局部和全身抗真菌药物治疗以及局部环孢素治疗。5个月后的随访检查显示,巩膜补片移植成功维持了眼球的完整性并恢复了部分视力。

结论

真菌性巩膜炎可能会被误诊为手术诱发的坏死性巩膜炎。早期诊断和及时治疗可预防疾病进展及进一步的严重并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c19/3917516/efa752f9922a/1752-1947-7-288-1.jpg

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