Jones S, Cohen E J, Arentsen J J, Laibson P R
Cornea Service, Wills Eye Hospital, Philadelphia, Pennsylvania 19107.
Cornea. 1988;7(4):295-9.
Streptococcal infections are an important cause of corneal ulcers, endophthalmitis, conjunctivitis, and dacryocystitis. We retrospectively reviewed 53 ocular streptococcal infections diagnosed and followed at Wills Eye Hospital between January 1, 1984, and July 1, 1986. Corneal ulcers (23 of 53; 43%) and endophthalmitis (18 of 53; 34%) constituted a majority of the streptococcal infections in this series. Streptococcal infection was also a common cause of conjunctivitis, but clinical follow-up data were sufficient for inclusion in this series in only a small fraction of conjunctivitis patients (9 of 70; 13%). Streptococcal corneal ulcers and endophthalmitis were frequently associated with a poor visual outcome. When antibiotic sensitivity testing was done, approximately one third of the streptococcal isolates (13 of 38; 34%) were not sensitive to gentamicin. As topical gentamicin is frequently used by ophthalmologists, the possibility of streptococcal infection should be taken into account in the selection of antibiotics for conjunctivitis, corneal ulcers, endophthalmitis, and prophylaxis.
链球菌感染是角膜溃疡、眼内炎、结膜炎和泪囊炎的重要病因。我们回顾性研究了1984年1月1日至1986年7月1日期间在威尔斯眼科医院确诊并随访的53例眼部链球菌感染病例。角膜溃疡（53例中的23例；43%）和眼内炎（53例中的18例；34%）在本系列链球菌感染中占大多数。链球菌感染也是结膜炎的常见病因，但只有一小部分结膜炎患者（70例中的9例；13%）有足够的临床随访数据纳入本系列。链球菌性角膜溃疡和眼内炎常导致视力预后不良。进行抗生素敏感性试验时，约三分之一的链球菌分离株（38例中的13例；34%）对庆大霉素不敏感。由于眼科医生经常使用局部庆大霉素，因此在选择治疗结膜炎、角膜溃疡、眼内炎及预防用药时应考虑链球菌感染的可能性。
