二氧化碳嗜纤维菌性角膜炎：临床表现及宏基因组深度测序在诊断中的应用
Capnocytophaga Keratitis: Clinical Presentation and Use of Metagenomic Deep Sequencing for Diagnosis.
作者信息
Seitzman Gerami D, Thulasi Praneetha, Hinterwirth Armin, Chen Cindi, Shantha Jessica, Doan Thuy
机构信息
Francis I. Proctor Foundation, University of California San Francisco, San Francisco, CA.
Department of Ophthalmology, University of California, San Francisco, CA.
出版信息
Cornea. 2019 Feb;38(2):246-248. doi: 10.1097/ICO.0000000000001790.
PURPOSE
To report our experience with 2 cases of Capnocytophaga keratitis.
METHODS
This is a retrospective study of case reports. We present the clinical presentation, diagnosis, and treatment strategies of 2 patients who presented with Capnocytophaga keratitis.
RESULTS
Both patients had risk factors including systemic immune compromise and ocular trauma. Both patients had robust inflammatory keratitis with necrosis. Case 1 demonstrates identification of Capnocytophaga with traditional microbiologic techniques. Case 2 demonstrates the use of unbiased metagenomic deep sequencing for identification of this unusual corneal pathogen.
CONCLUSIONS
Capnocytophaga is a rare and aggressive infection. Even when traditional culture identifies the pathogen rapidly, keratitis can progress to perforation. In cases of severe keratitis in which traditional culture methods are unrevealing, metagenomic deep sequencing has potential to provide actionable diagnoses.
目的
报告我们对2例二氧化碳嗜纤维菌角膜炎的治疗经验。
方法
这是一项对病例报告的回顾性研究。我们介绍了2例患有二氧化碳嗜纤维菌角膜炎患者的临床表现、诊断和治疗策略。
结果
两名患者均有包括全身免疫功能低下和眼外伤在内的危险因素。两名患者均患有伴有坏死的严重炎症性角膜炎。病例1展示了用传统微生物学技术鉴定二氧化碳嗜纤维菌。病例2展示了使用无偏差宏基因组深度测序来鉴定这种不常见的角膜病原体。
结论
二氧化碳嗜纤维菌是一种罕见且侵袭性强的感染。即使传统培养能迅速鉴定出病原体，角膜炎仍可能进展至穿孔。在传统培养方法无法揭示病因的严重角膜炎病例中，宏基因组深度测序有提供可采取行动的诊断结果的潜力。
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