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翼状胬肉切除术后发生粘质沙雷氏菌眼内炎:一例报告

Serratia marcescens endophthalmitis after pterygium surgery: a case report.

作者信息

Yi Myeong Yeon, Chung Jin Kwon, Choi Kyung Seek

机构信息

Department of Ophthalmology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, 59 Daesagwan-ro, Yongsan-gu, Seoul, 140-743, Korea.

出版信息

BMC Ophthalmol. 2017 Nov 2;17(1):197. doi: 10.1186/s12886-017-0590-4.

Abstract

BACKGROUND

To report a case of Serratia marcescens endophthalmitis after pterygium surgery using the bare sclera technique with mitomycin C (MMC).

CASE PRESENTATION

A 69-year-old male patient underwent pterygium excision surgery using the bare sclera technique and 0.02% MMC. The patient presented with decreased visual acuity and pain from the day after the operation. Trans pars plana vitrectomy was performed and intravitreal antibiotics were administered. Cultures from the aqueous humor and intraocular lens were all positive for S. marcescens, which was sensitive to an empiric antibiotic regimen. The best corrected distant visual acuity, 1 month after treatment, was a finger count/50 cm, but the retinal layer structure and the vasculature were relatively well preserved.

CONCLUSIONS

This is the first reported case of S. marcescens endophthalmitis after pterygium surgery. Endophthalmitis caused by S. marcescens has a devastating visual prognosis and may show a high clinical risk-benefit ratio for the application of MMC in pterygium surgery.

摘要

背景

报告1例采用裸巩膜技术联合丝裂霉素C(MMC)行翼状胬肉切除术后发生粘质沙雷氏菌性眼内炎的病例。

病例报告

1例69岁男性患者采用裸巩膜技术及0.02%MMC行翼状胬肉切除术。术后次日患者即出现视力下降及疼痛。行玻璃体切割术并给予玻璃体内注射抗生素。房水及人工晶状体培养均显示粘质沙雷氏菌阳性,该菌对经验性抗生素治疗方案敏感。治疗1个月后,最佳矫正远视力为手指计数/50cm,但视网膜层结构及血管系统相对保存良好。

结论

这是首例翼状胬肉切除术后发生粘质沙雷氏菌性眼内炎的报告。粘质沙雷氏菌所致眼内炎视力预后极差,且在翼状胬肉手术中应用MMC可能具有较高的临床风险效益比。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c67/5668964/e7cb53d5ebc6/12886_2017_590_Fig1_HTML.jpg

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