Miyamura Yuka, Sotozono Chie, Higashihara Hisayo, Hoshi Saichi, Kinoshita Shigeru
Nippon Ganka Gakkai Zasshi. 2015 Dec;119(12):863-7.
Purpose : To report 3 cases of severe ocular infection in elderly patients with dementia.
Case 1 involved a 75-year-old man who presented after his wife noticed hyperemia and discharge in his right eye. Corneal infection with perforation was found. Wife-administered antibiotics healed the infection within 1 month. Case 2 involved a 97-year-old man who was referred to us after nursing-home staff members noticed redness and discharge in his right eye. Severe corneal infection with hypopyon was found. Following systemic and topical and antibiotics' administration by the nursing-home staff, the infectious keratitis healed within 2 weeks. Case 3 involved an 80-year-old woman referred to us from another clinic due to persistent epithelial defect in her left eye. Since the defect was accompanied by anterior uveitis and vitreous opacity, we suspected bacterial endophthalmitis. Following systemic and topical antibiotics' administration by family members, signs of infection diminished within 3 weeks. In all 3 cases, medical examination was difficult, topical eye-drop instillation by the patients themselves was impossible.
In elderly dementia patients, cognizance of infection, medical examination, and treatment are difficult. Support by family members or nursing-home staff is necessary to obtain improved outcomes.
目的:报告3例老年痴呆患者的严重眼部感染病例。
病例1为一名75岁男性,其妻子发现他右眼充血并有分泌物后前来就诊。发现角膜感染伴穿孔。由其妻子给予抗生素治疗,1个月内感染痊愈。病例2为一名97岁男性,养老院工作人员发现他右眼发红并有分泌物后将他转诊至我们这里。发现严重角膜感染伴前房积脓。在养老院工作人员给予全身和局部抗生素治疗后,感染性角膜炎在2周内痊愈。病例3为一名80岁女性,因左眼持续性上皮缺损从另一家诊所转诊至我们这里。由于缺损伴有前葡萄膜炎和玻璃体混浊,我们怀疑是细菌性眼内炎。在家庭成员给予全身和局部抗生素治疗后,感染迹象在3周内减轻。在所有3例病例中,医学检查困难,患者自身无法滴入局部眼药水。
在老年痴呆患者中,感染的认知、医学检查和治疗都很困难。需要家庭成员或养老院工作人员的支持以获得更好的治疗效果。