Yang Michael C, Ling John, Mosaed Sameh
Department of Ophthalmology, Gavin Herbert Eye Institute, University of California, Irvine, CA, 92697, USA.
BMC Ophthalmol. 2021 Jan 26;21(1):59. doi: 10.1186/s12886-021-01823-8.
Capnocytophaga canimorsus is a facultative anaerobic, slow-growing, capnophilic, Gram-negative bacillus, that is commonly found in the microflora of canine and feline oral cavities. Capnocytophaga infections are an emerging zoonotic disease that can cause fatal systemic infections in immunocompromised individuals. Localized ocular Capnocytophaga infections, including keratitis, blepharitis, and endophthalmitis, can lead to severe eye threatening situations. To our knowledge, there is currently no documented case of Capnocytophaga canimorsus blebitis with bleb perforation after trabeculectomy.
Our case report and literature review features a novel case of Capnocytophaga blebitis that occurred after trabeculectomy, associated with close dog contact (i.e. face licking). The patient had underwent trabeculectomy 10 years prior and presented with conjunctival injection, perforated bleb, and hypotony. Overall, patient was medically treated subconjunctival vancomycin, gentamicin and moxifloxacin drops. Trabeculectomy revision was performed with good visual outcome. Bacterial cultures grew Capnocytophaga canimorsus.
We discuss the strategies for diagnosis, treatment, and common risk factors for ocular Capnocytophaga infections. At-risk patients with ocular infections should be asked about close contact with dogs and cats; and treated promptly with the proper antibiotic regimen.
犬咬二氧化碳嗜纤维菌是一种兼性厌氧、生长缓慢、嗜二氧化碳、革兰氏阴性杆菌,常见于犬类和猫类口腔微生物群中。犬咬二氧化碳嗜纤维菌感染是一种新出现的人畜共患病,可在免疫功能低下的个体中引起致命的全身感染。局部眼部犬咬二氧化碳嗜纤维菌感染,包括角膜炎、睑缘炎和眼内炎,可导致严重威胁视力的情况。据我们所知,目前尚无小梁切除术后发生犬咬二氧化碳嗜纤维菌性睑裂斑炎伴睑裂斑穿孔的病例报道。
我们的病例报告和文献综述描述了一例小梁切除术后发生的新型犬咬二氧化碳嗜纤维菌性睑裂斑炎病例,与密切接触犬类(即面部舔舐)有关。该患者10年前接受了小梁切除术,出现结膜充血、睑裂斑穿孔和低眼压。总体而言,患者接受了结膜下注射万古霉素、庆大霉素和莫西沙星滴眼液的药物治疗。进行了小梁切除术修复,视力恢复良好。细菌培养结果为犬咬二氧化碳嗜纤维菌。
我们讨论了眼部犬咬二氧化碳嗜纤维菌感染的诊断、治疗策略及常见危险因素。对于有眼部感染风险的患者,应询问其是否与犬类和猫类密切接触;并及时采用适当的抗生素方案进行治疗。