顽固性角膜炎
Recalcitrant keratitis.
作者信息
Lakshmi Seetha, Garcia Cristina Vanessa
机构信息
Department of Infectious Disease, University of South Florida, Tampa, Florida, USA.
出版信息
BMJ Case Rep. 2019 Apr 24;12(4):e229226. doi: 10.1136/bcr-2019-229226.
A 54-year-old Caucasian woman presented with corneal ulcer of the right eye of 4 weeks duration after scratching her cornea while removing her contact lens and artificial eye lashes. Her visual acuity was 20/32 (left eye) and finger counting (right eye). She had a 3x3 mm epithelial defect with underlying corneal oedema and hypopyon. Right eye cultures grew species. Topical and systemic antifungal agents were initiated. Due to the sight-threatening disease, the patient underwent surgical intervention with intrastromal injection of amphotericin B and a large conjunctival flap covering 75% of the right eye corneal ulcer. After 3 months of therapy, she had near-complete resolution of the corneal ulcer. Unfortunately, recurrence of the corneal ulcer occurred within 3 weeks of cessation of therapy, prompting reinitiation of ophthalmic and systemic antifungal agents. The patient was advised to continue therapy for 6 months with regular follow-up.
一名54岁的白种女性，在摘除隐形眼镜和人工睫毛时划伤角膜，出现了持续4周的右眼角膜溃疡。她的视力为20/32（左眼）和眼前指数（右眼）。她有一个3×3毫米的上皮缺损，伴有角膜水肿和前房积脓。右眼培养出了[具体菌种未给出]。开始使用局部和全身抗真菌药物。由于该疾病威胁视力，患者接受了手术干预，进行了基质内注射两性霉素B以及覆盖右眼角膜溃疡75%的大结膜瓣手术。经过3个月的治疗，角膜溃疡几乎完全愈合。不幸的是，在治疗停止后3周内角膜溃疡复发，促使重新开始使用眼科和全身抗真菌药物。建议患者继续治疗6个月并定期随访。
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