Venkatesh Ramesh, Gurav Prachi, Agarwal Manisha, Sapra Neelam, Dave Prachi Abhishek
Retina & Vitreous Department, Dr Shroff Charity Eye Hospital, 5027, Kedarnath Road, Daryaganj, New Delhi, 110002, India.
Ocular Microbiology Department, Dr Shroff Charity Eye Hospital, 5027, Kedarnath Road, Daryaganj, New Delhi, 110002, India.
J Ophthalmic Inflamm Infect. 2017 Dec;7(1):9. doi: 10.1186/s12348-017-0128-1. Epub 2017 Mar 14.
The purpose of this study is to report a case of ocular infection with Gliocladium species due to an exposed scleral buckle.
Interventional case report was used as the study design.
A 60-year-old diabetic male patient presented with persistent pain, redness, and discharge in his left eye since 2 months. He had been treated previously with both topical and systemic steroids for a diagnosis of autoimmune scleritis. He had undergone scleral buckling surgery with cryotherapy for an inferior rhegmatogenous retinal detachment in the past. His best-corrected visual acuity was 6/6, N6 and 6/6, N6 in the right and left eyes, respectively. Retraction of the left lower lid revealed an exposed scleral buckle with an overlying necrotic conjunctiva. Scleral buckle removal was done. Microbiological examination showed Gliocladium species growing on blood agar and Sabouraud dextrose agar. Treatment was started with topical antifungal medication and oral antibiotics.
Following treatment, signs of infection showed resolution. Patient underwent retinal reattachment surgery with favorable anatomic and visual outcome.
Ocular infection with Gliocladium species has not been previously reported. Poor response to steroids and uncontrolled diabetes should make the clinician aware of a possible fungal infection. Removal of the scleral buckle, identification of the causative organism, and use of appropriate antibiotics are important for the accurate management of the case.
本研究旨在报告一例因巩膜扣外露导致的眼内胶霉属真菌感染病例。
采用介入性病例报告作为研究设计。
一名60岁的糖尿病男性患者，自2个月前起左眼持续疼痛、发红并伴有分泌物。他此前因自身免疫性巩膜炎诊断接受过局部和全身类固醇治疗。他曾在过去因下方孔源性视网膜脱离接受过巩膜扣带术联合冷冻疗法。他的最佳矫正视力右眼为6/6，N6，左眼为6/6，N6。左下眼睑回缩显示巩膜扣外露，其上覆盖坏死性结膜。进行了巩膜扣移除。微生物学检查显示在血琼脂和沙氏葡萄糖琼脂上生长有胶霉属真菌。开始使用局部抗真菌药物和口服抗生素治疗。
治疗后，感染迹象消退。患者接受了视网膜复位手术，获得了良好的解剖和视觉效果。
此前尚未有胶霉属真菌感染眼部的报道。对类固醇反应不佳和糖尿病控制不佳应使临床医生意识到可能存在真菌感染。移除巩膜扣、识别致病微生物以及使用适当的抗生素对于准确处理该病例很重要。
