Dugel P U, Holland G N, Brown H H, Pettit T H, Hofbauer J D, Simons K B, Ullman H, Bath P E, Foos R Y
UCLA School of Medicine, Jules Stein Eye Institute, Los Angeles, CA 90024-1771.
Am J Ophthalmol. 1988 Jun 15;105(6):661-9. doi: 10.1016/0002-9394(88)90061-x.
Two of four cases of Mycobacterium fortuitum keratitis occurred after corneal surgery with contact lens wear, one was associated with extended contact lens wear alone, and one occurred after a foreign body injury. All cases were characterized by pain, conjunctival hyperemia, stromal inflammation, and ulceration. Diagnosis was made by culture and acid-fast staining of corneal scrapings. On the basis of published experience with amikacin for the treatment of nonocular M. fortuitum infections, three patients were treated with topical amikacin. Two patients responded clinically, but histopathologic examination of a penetrating keratoplasty specimen in one of the two disclosed persistent infection. One patient was cured of early disease by debridement alone. Rapid diagnosis and absence of corticosteroid use were the two most important determinants of successful therapy. In advanced cases, infection may be cured and useful vision restored by penetrating keratoplasty.
四例偶然分枝杆菌性角膜炎患者中，有两例发生于角膜手术后并佩戴隐形眼镜，一例仅与长期佩戴隐形眼镜有关，另一例发生于异物损伤后。所有病例均有疼痛、结膜充血、基质炎症和溃疡的表现。通过角膜刮片培养和抗酸染色进行诊断。根据已发表的关于阿米卡星治疗非眼部偶然分枝杆菌感染的经验，对三名患者使用局部阿米卡星进行治疗。两名患者临床症状有改善，但其中一名患者穿透性角膜移植标本的组织病理学检查显示仍有持续性感染。一名患者仅通过清创就治愈了早期疾病。快速诊断和不使用皮质类固醇是成功治疗的两个最重要决定因素。在晚期病例中，穿透性角膜移植术可能治愈感染并恢复有用视力。
