Spadea Leopoldo, Abbouda Alessandro, Abicca Irene, Paroli Maria Pia
Department of Medical-Surgical Sciences and Biotechnology, "Sapienza" University of Rome, Latina, Italy.
, Via Benozzo Gozzoli 34, 00142, Rome, Italy.
Int Ophthalmol. 2015 Feb;35(1):145-8. doi: 10.1007/s10792-014-0030-x. Epub 2014 Dec 9.
To report the clinical findings and management of a case of Aspergillus flavus endophthalmitis following penetrating keratoplasty (PKP) and combined cataract extraction. Clinical cornea appearance was evaluated by slit-lamp examination. Ocular ultrasonography was performed to evaluate the anterior chamber and vitreous cavity. The cornea was scraped. The corneal-scleral donor rim and media were cultured. The diagnosis of A. flavus infection was made. The patient received fortified antifungal drops (voriconazole 1 % solution) plus systemic voriconazole 400 mg/die. A second corneal transplant was performed, and the anterior chamber was cleaned and washed with a solution of voriconazole 1 %. At the end of follow-up, CDVA was 20/20 and slit-lamp examination showed a clear cornea graft. This case illustrates a severe A. flavus endophthalmitis after PKP and demonstrates the possibilities of visual function restoration. Furthermore, this case describes the different sources of fungal infection after PKP and the different clinical appearances.
报告一例穿透性角膜移植术（PKP）联合白内障摘除术后黄曲霉性眼内炎的临床发现及治疗情况。通过裂隙灯检查评估临床角膜外观。进行眼部超声检查以评估前房和玻璃体腔。刮取角膜组织。对角膜-巩膜供体边缘及眼内介质进行培养。确诊为黄曲霉感染。患者接受强化抗真菌滴眼液（1%伏立康唑溶液）加全身应用伏立康唑400毫克/天治疗。进行了第二次角膜移植，并使用1%伏立康唑溶液清洁和冲洗前房。随访结束时，最佳矫正视力（CDVA）为20/20，裂隙灯检查显示角膜移植片清晰。该病例说明了PKP术后严重的黄曲霉性眼内炎，并展示了视觉功能恢复的可能性。此外，该病例描述了PKP术后真菌感染的不同来源及不同临床表现。
