Ormerod L D, Foster C S, Paton B G, Haaf J, Baker A S
Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA 02114.
Cornea. 1988;7(3):218-22.
Severe microbial keratitis developed in a 74-year-old women receiving long-term corticosteroids. Corneal smears revealed slender, fusiform gram-negative bacilli, but the lesion continued to worsen despite intensive antibiotic treatment. After several days, Capnocytophaga sputigena was identified on culture. Specific antimicrobial therapy was instituted, supplemented with corneal cryotherapy. There was gradual clinical improvement. However, a sterile corneal melt led to the late loss of the eye. Although Capnocytophaga are gingival organisms and usually implicated as opportunists in severely ill, neutropenic patients with oral ulcerations, our patient was edentulous and without systemic immunosuppression. An increased awareness of Capnocytophaga is justified because of their widespread antibiotic resistance, capnophilic cultural requirements, and unusual microscopic and cultural morphology.
一名长期接受皮质类固醇治疗的74岁女性发生了严重的微生物性角膜炎。角膜涂片显示细长、梭形革兰氏阴性杆菌，但尽管进行了强化抗生素治疗，病变仍继续恶化。几天后，培养物中鉴定出牙龈二氧化碳嗜纤维菌。开始进行特异性抗菌治疗，并辅以角膜冷冻疗法。临床症状逐渐改善。然而，无菌性角膜溶解导致后期眼球丧失。尽管二氧化碳嗜纤维菌是口腔微生物，通常在患有口腔溃疡的重症、中性粒细胞减少患者中作为机会致病菌，但我们的患者无牙且没有全身免疫抑制。鉴于二氧化碳嗜纤维菌广泛的抗生素耐药性、嗜二氧化碳培养要求以及不寻常的显微镜和培养形态，提高对其的认识是合理的。
