Departamento de Oftalmología, Hospital Clínico Universitario de Valencia, Valencia, España.
Departamento de Oftalmología, Hospital Clínico Universitario de Valencia, Valencia, España.
Arch Soc Esp Oftalmol (Engl Ed). 2020 Jul;95(7):357-360. doi: 10.1016/j.oftal.2020.02.012. Epub 2020 Mar 30.
Moraxella keratitis can lead to important complications. Moraxella nonliquefaciens(M. nonliquefaciens) has the worst prognosis. Only three cases of corneal infections due to M. nonliquefaciens have been published. The case is presented of a 79-year-old man with bullous keratopathy, recently affected with severe infectious keratitis. Dense, deep, and central stromal infiltrates and hyphaema were detected. After the identification of M. nonliquefaciens in the culture, and given the progression of the condition, the initial empirical treatment was modified to topical ciprofloxacin and ceftazidime in accordance with the antibiogram, combining oral ciprofloxacin and amoxicillin-clavulanate. After 27 days, there was total resolution of the lesion, with central residual leucoma. Keratitis caused by M. nonliquefaciens is rare and must be suspected in elderly patients with local predisposing factors, such as corneal damage or previous eye surgery. Early antibiogram-guided treatment and close monitoring are important to avoid complications and poor compliance.
莫拉氏菌角膜炎可导致严重并发症,其中解没食子酸莫拉氏菌(M. nonliquefaciens)的预后最差。目前仅有 3 例由 M. nonliquefaciens 引起的角膜感染病例报道。本文报告了 1 例 79 岁男性,患有大疱性角膜病变,近期发生严重感染性角膜炎。检查发现密集、深层且位于中央基质的浸润和前房积血。在培养中鉴定出 M. nonliquefaciens 后,鉴于病情进展,初始经验性治疗根据药敏试验结果调整为局部应用环丙沙星和头孢他啶,并联合口服环丙沙星和阿莫西林克拉维酸。27 天后,病变完全消退,中央遗留角膜白斑。解没食子酸莫拉氏菌引起的角膜炎较为罕见,对于有局部易感因素(如角膜损伤或先前眼部手术)的老年患者,应怀疑该病。早期进行药敏试验指导下的治疗和密切监测对于避免并发症和改善患者依从性至关重要。