Suzuki Reina, Kuroda Hitoshi, Matsubayashi Hiroshi, Ishii Akira, Toyoda Fumihiko, Kawarai Lefor Alan, Sugawara Hitoshi
Division of General Medicine, Department of Comprehensive Medicine 1, Saitama Medical Center, Jichi Medical University, Japan.
Intern Med. 2015;54(20):2693-8. doi: 10.2169/internalmedicine.54.4691. Epub 2015 Oct 15.
A 51-year-old Japanese woman developed candidemia as an outpatient secondary to a Candida albicans upper urinary tract infection complicated by previously undiagnosed type 2 diabetes mellitus with poor glycemic control and ureterolithiasis. The patient did not have any risk factors typically associated with candidemia, such as an indwelling vascular catheter, parenteral nutrition or broad-spectrum antibiotic use. During the clinical course, her condition was complicated by unilateral candida endophthalmitis, which progressed despite the administration of systemic antifungal agents and ultimately required vitreous surgery. The etiology of candidemia in this patient and the reason she developed progressive ocular symptoms after starting antifungal treatment are reviewed.
一名51岁的日本女性在门诊时发生念珠菌血症,继发于白色念珠菌引起的上尿路感染,并发先前未诊断出的2型糖尿病,血糖控制不佳以及输尿管结石。该患者没有任何通常与念珠菌血症相关的危险因素,如留置血管导管、肠外营养或使用广谱抗生素。在临床过程中,她的病情并发单侧念珠菌性眼内炎,尽管给予了全身抗真菌药物治疗,但病情仍进展,最终需要进行玻璃体手术。本文回顾了该患者念珠菌血症的病因以及她在开始抗真菌治疗后出现进行性眼部症状的原因。