Bourcier T, Sauer A, Dory A, Denis J, Sabou M
Service d'ophtalmologie, Nouvel hôpital civil, EA7290, FMTS, hôpitaux universitaires, université de Strasbourg, 1, place de l'Hôpital, BP 426, 67091 Strasbourg cedex, France.
Service d'ophtalmologie, Nouvel hôpital civil, EA7290, FMTS, hôpitaux universitaires, université de Strasbourg, 1, place de l'Hôpital, BP 426, 67091 Strasbourg cedex, France.
J Fr Ophtalmol. 2017 Dec;40(10):882-888. doi: 10.1016/j.jfo.2017.05.013. Epub 2017 Nov 14.
Fungal keratitis, or keratomycoses, are corneal infections which must be considered in cases of corneal trauma, prior corneal surgery, chronic ocular surface disease, topical corticosteroids or contact lens wear. Filamentous fungi or yeasts may be involved. Presenting clinical features such as corneal infiltrates with feathery edges and/or raised surface, intact epithelium with deep stromal involvement, satellite lesions, endothelial plaques, lack of improvement with antibiotics and worsening with steroids are suggestive of fungal keratitis. Corneal scraping for laboratory examination is mandatory. Medical management with antifungal eye drops and systemic agents should be started as soon as possible. Surgical interventions are required in a significant number of cases to control the infection. The prognosis of fungal keratitis is worse than that of bacterial keratitis.
真菌性角膜炎,或称角膜真菌病,是一种角膜感染,在角膜外伤、既往角膜手术、慢性眼表疾病、局部使用皮质类固醇或佩戴隐形眼镜的情况下都必须予以考虑。丝状真菌或酵母菌可能与之相关。其临床表现,如角膜浸润伴有羽状边缘和/或表面隆起、上皮完整但基质深层受累、卫星病灶、内皮斑块、使用抗生素后无改善而使用类固醇后病情恶化等,提示为真菌性角膜炎。必须进行角膜刮片以作实验室检查。应尽快开始使用抗真菌滴眼液和全身用药进行药物治疗。在相当多的病例中需要进行手术干预以控制感染。真菌性角膜炎的预后比细菌性角膜炎更差。