Droutsas Konstantinos, Kalantzis Georgios, Symeonidis Chrysanthos, Georgalas Ilias
1st Department of Ophthalmology, University of Athens, General Hospital "G. Gennimatas", Mesogeion Avenue 158, 156 69 Athens, Greece.
2nd Department of Ophthalmology, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital, Thessaloniki Ring Road, 564 03 Thessaloniki, Macedonia.
Case Rep Ophthalmol Med. 2015;2015:192864. doi: 10.1155/2015/192864. Epub 2015 Dec 29.
A rare case of Sphingomonas paucimobilis endophthalmitis secondary to a penetrating globe injury with a retained intraocular foreign body is presented. A 30-year-old man presented with severe pain following a penetrating left eye injury. Visual acuity (VA) was 6/120. Slit-lamp examination revealed perforation of the temporal cornea and iris, hypopyon, and a fibrinous membrane covering the pupil. Ultrasonography showed dense vitreous infiltration and an orbital CT-scan confirmed the presence of a metallic foreign body in the vitreous cavity. Topical and systemic therapy were initiated. Pars-plana vitrectomy combined with phacoemulsification was performed in order to remove the foreign body; vitreous samples were acquired and Sphingomonas paucimobilis, sensitive to ceftazidime, was identified. To the best of our knowledge, this is the first report of Sphingomonas paucimobilis endophthalmitis following penetrating ocular injury. In this case, Sphingomonas paucimobilis was not resistant to antibiotics. This allowed for a good healing response following vitrectomy despite the fact that long-term retinal complications resulted in low VA.
本文报告了一例罕见的少动鞘氨醇单胞菌性眼内炎,继发于眼球穿通伤并伴有眼内异物残留。一名30岁男性因左眼穿通伤后出现剧痛就诊。视力(VA)为6/120。裂隙灯检查发现颞侧角膜和虹膜穿孔、前房积脓以及覆盖瞳孔的纤维蛋白膜。超声检查显示玻璃体致密浸润,眼眶CT扫描证实玻璃体腔内存在金属异物。开始进行局部和全身治疗。为取出异物进行了玻璃体切割联合超声乳化术;采集了玻璃体样本,鉴定出对头孢他啶敏感的少动鞘氨醇单胞菌。据我们所知,这是眼球穿通伤后少动鞘氨醇单胞菌性眼内炎的首例报告。在该病例中,少动鞘氨醇单胞菌对抗生素不耐药。尽管长期视网膜并发症导致视力低下,但玻璃体切除术后仍获得了良好的愈合反应。