Kuerten D, Fuest M, Mazinani B, Walter P, Plange N
Klinik für Augenheilkunde, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.
Ophthalmologe. 2018 Feb;115(2):145-149. doi: 10.1007/s00347-017-0439-5.
Intraocular Candida infections are overall rather rare; nevertheless they are often found as endogenous infections after Candida sepsis and can be sight-threatening. The most common manifestations are either a sole chorioretinitis or an endophthalmitis. Here we report the case of a 35-year-old man developing Candida infiltrations in the lens capsule and behind the iris after corticosteroid treatment of a presumed HLA-B27-positive iritis. The patient suffered from a life-threatening intensive care stay with positive Candida blood cultures earlier after intestinal perforation. With systemic intracameral and topical voriconazole, the infection was successfully treated. In patients with positive blood samples for Candida, topical and systemic corticosteroids should be given with care even months after the last positive blood cultures.
眼内念珠菌感染总体上相当罕见;然而,它们常作为念珠菌败血症后的内源性感染被发现,且可能威胁视力。最常见的表现要么是单纯性脉络膜视网膜炎,要么是眼内炎。在此,我们报告一例35岁男性病例,该患者在假定为HLA - B27阳性虹膜睫状体炎接受皮质类固醇治疗后,晶状体囊膜和虹膜后出现念珠菌浸润。该患者早些时候因肠穿孔在重症监护病房接受治疗,生命垂危,血培养念珠菌呈阳性。通过全身前房内及局部应用伏立康唑,感染得到成功治疗。对于血样念珠菌检测呈阳性的患者,即使在最后一次血培养呈阳性数月后,使用局部和全身皮质类固醇也应谨慎。