Micheletti John M, Agrawal Megha, Matoba Alice Y, Marx Douglas P
Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, U.S.A.
Ophthalmic Plast Reconstr Surg. 2015 Sep-Oct;31(5):e131-2. doi: 10.1097/IOP.0000000000000201.
Nocardial conjunctivitis associated with silicone tubing is an extremely rare finding. The authors present a case of a 52-year-old woman with previous dacryocystorhinostomy and silicone tube placement 3 years prior who presented with OD redness and discharge for 1 week. On examination, the patient was noted to have mucoid discharge and crusting surrounding the silicone tube. The tube debris was sampled, and the culture was positive for Nocardia nova complex sensitive to trimethoprim/sulfamethoxazole and amikacin. Silicone tube colonization and N. nova complex conjunctivitis are both rare but should be considered in the differential diagnosis of patients with indwelling silicone tubes presenting with chronic conjunctivitis resistant to fluoroquinolones and tobramycin.
与硅胶管相关的诺卡菌性结膜炎是一种极其罕见的病症。作者报告了一例52岁女性病例，该患者3年前曾行泪囊鼻腔吻合术并植入硅胶管，此次因右眼发红、分泌物增多1周前来就诊。检查发现，患者硅胶管周围有黏液性分泌物和结痂。对硅胶管碎片进行采样，培养结果显示诺卡菌新菌复合群呈阳性，该菌对甲氧苄啶/磺胺甲恶唑和阿米卡星敏感。硅胶管定植和诺卡菌新菌复合群结膜炎均较为罕见，但在诊断植入硅胶管且患有对氟喹诺酮类药物和妥布霉素耐药的慢性结膜炎患者时应予以考虑。
