隐匿性真菌性巩膜炎
Occult Fungal Scleritis.
作者信息
Jeang Lauren J, Davis Aaron, Madow Brian, Espana Edgar M, Margo Curtis E
机构信息
Department of Ophthalmology, Morsani College of Medicine, University of South Florida, Tampa, Fla., USA.
Department of Ophthalmology, Morsani College of Medicine, University of South Florida, Tampa, Fla., USA; Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, Fla., USA.
出版信息
Ocul Oncol Pathol. 2017 Jan;3(1):41-44. doi: 10.1159/000449103. Epub 2016 Sep 14.
PURPOSE
To heighten awareness of occult fungal scleritis.
METHOD
Case report and review of the literature.
RESULTS
A 73-year-old woman with diabetes mellitus was diagnosed for 3 months with immune-mediated scleritis and subsequently treated with corticosteroids. On referral, the patient had a scleral nodule with contiguous corneal infiltrate and hypopyon. Culture grew species not further classified. The infection could not be controlled with antifungal therapy, and the eye was removed. No exogenous or endogenous source for the infection could be identified by clinical history or examination.
CONCLUSION
Fungal scleritis can develop in persons without a history of foreign body injury, minor trauma, or evidence of endogenous fungemia. A high index of suspicion for infectious scleritis must be maintained in persons with presumed immune-mediated scleritis who fail to respond to conventional therapy, particularly if they present with decreased visual acuity.
目的
提高对隐匿性真菌性巩膜炎的认识。
方法
病例报告及文献复习。
结果
一名73岁糖尿病女性患者被诊断为免疫介导性巩膜炎3个月，随后接受了皮质类固醇治疗。转诊时，患者有一个巩膜结节，伴有相邻的角膜浸润和前房积脓。培养出未进一步分类的菌种。抗真菌治疗无法控制感染，遂摘除眼球。通过临床病史或检查未发现感染的外源性或内源性来源。
结论
真菌性巩膜炎可发生于无异物损伤、轻微外伤史或内源性真菌血症证据的患者。对于疑似免疫介导性巩膜炎但对传统治疗无反应的患者，尤其是视力下降的患者，必须高度怀疑感染性巩膜炎。
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