Dalvin Lauren A, Thom Steven B, García Joaquín J, Fadel Hind J, Baratz Keith H
*Department of Ophthalmology, Mayo Clinic, Rochester, MN; †Thom Eye & Laser Clinic, Fargo, ND; Departments of ‡Laboratory Medicine and Pathology; and §Infectious Disease, Mayo Clinic, Rochester, MN.
Cornea. 2016 Mar;35(3):402-4. doi: 10.1097/ICO.0000000000000733.
To describe the first-documented case of histoplasma scleritis in an immunocompetent patient.
Medical and pathological records of the patient described were reviewed.
A 77-year-old immunocompetent man presented with necrotizing scleritis. Biopsy was consistent with histoplasma species, and culture results confirmed a causative agent of Histoplasma capsulatum. The patient required a long course of treatment, which included topical voriconazole and amphotericin, oral itraconazole and voriconazole, intravenous amphotericin, and periocular voriconazole and amphotericin. After 8 months of treatment, the patient's scleritis resolved, and he maintained good visual acuity.
To our knowledge, this is the second report of histoplasma scleritis in the literature and the first report in an immunocompetent patient.
描述首例有记录的免疫功能正常患者的组织胞浆菌性巩膜炎病例。
对所述患者的医学和病理记录进行回顾。
一名77岁免疫功能正常的男性出现坏死性巩膜炎。活检结果与组织胞浆菌属相符，培养结果证实病原体为荚膜组织胞浆菌。患者需要长期治疗，包括局部使用伏立康唑和两性霉素、口服伊曲康唑和伏立康唑、静脉注射两性霉素以及眼周注射伏立康唑和两性霉素。经过8个月的治疗，患者的巩膜炎消退，视力保持良好。
据我们所知，这是文献中关于组织胞浆菌性巩膜炎的第二篇报道，也是免疫功能正常患者中的首例报道。
