玻璃体内注射地塞米松植入物后发生干酪短杆菌性眼内炎。
Brevibacterium casei endophthalmitis after intravitreal dexamethasone implant.
作者信息
Olate-Pérez A, Díaz-Céspedes R A, Ruíz-Del-Río N, Hernández-Pérez D, Duch-Samper A
机构信息
Institut Clínic d'Oftalmologia, Hospital Clínic, Barcelona, España.
Servicio de Oftalmología, Hospital de Manises, Manises, Valencia, España.
出版信息
Arch Soc Esp Oftalmol (Engl Ed). 2020 Dec 3. doi: 10.1016/j.oftal.2020.09.007.
CLINICAL CASE
A 49-year-old man with diabetic macular edema refractory to antiangiogenics was treated with intravitreal dexamethasone implant (Ozurdex; Allergan, California, USA). Seven days after treatment, he showed acute endophthalmitis suggestive signs. Despite the intravitreal injection of antibiotics, the patient got worse. Vitreous sampling was repeated for Gram and cultures, and vitrectomy was performed via pars plana. The culture suggested the development of Brevibacterium species. Through an additional test, the presence of Brevibacterium casei was confirmed. Despite the treatment adjusted by antibiogram, retinal ischemia and macular atrophy was evident.
DISCUSION
Brevibacterium casei is a Gram-positive bacterium, barely pathogenic, that mainly affects immunodepressed patients. Only two cases of endophthalmitis are described, one endogenous and the other one secondary to vegetal trauma. This is the first case of Brevibacterium casei endophthalmitis, secondary to an ophthalmological procedure.
临床病例
一名49岁男性，患有对抗血管生成药物耐药的糖尿病性黄斑水肿，接受了玻璃体内地塞米松植入物（Ozurdex；美国加利福尼亚州艾尔建公司）治疗。治疗7天后，他出现了急性眼内炎的提示性体征。尽管进行了玻璃体内抗生素注射，患者病情仍恶化。重复进行玻璃体取样以进行革兰氏染色和培养，并通过睫状体平坦部进行了玻璃体切除术。培养结果提示短杆菌属细菌感染。通过进一步检测，证实存在干酪短杆菌。尽管根据药敏试验调整了治疗方案，但视网膜缺血和黄斑萎缩仍很明显。
讨论
干酪短杆菌是一种革兰氏阳性菌，致病性很弱，主要影响免疫功能低下的患者。仅描述了两例眼内炎病例，一例为内源性，另一例继发于植物性创伤。这是第一例继发于眼科手术的干酪短杆菌性眼内炎病例。
Zotero 插件