Baptista Pedro Manuel, Vieira Rita, Monteiro Sílvia, Abreu Ana Carolina, Gomes Miguel, Pinto Maria do Céu
Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal.
Instituto de Ciências Biomédicas Abel Salazar, Porto, Portugal.
Int Med Case Rep J. 2021 Feb 17;14:107-110. doi: 10.2147/IMCRJ.S299454. eCollection 2021.
To describe a rare case of an interface filamentous fungal keratitis and its successful clinical approach and management.
Retrospective case report. Analysis of the patient's clinical records.
A healthy 30-year-old woman presenting with complaints of blurred vision, photophobia and intense pain, was previously diagnosed with a suspected unilateral diffuse lamellar keratitis after laser in situ keratomileusis surgery, and accordingly treated with a scheme of oral and subconjunctival corticosteroids. Due to worsening of symptoms, the patient was later referred to our ophthalmology department. Upon examination, a corneal infiltration was observed and a fungal infection was suspected. Treatment with fortified Voriconazole (1%) was initiated and both topical and oral corticosteroids were tapered. The infiltrate resolved after 6 weeks of antifungal topical treatment. was isolated on culture media. At the end of follow-up, the uncorrected distance visual acuity was 20/20 with mild scarring.
can be associated with post-laser in situ keratomileusis interface infection. A quick intervention may dictate a good outcome, when combining early suspicion and microbiological diagnosis, and an appropriate conservative management. Furthermore, Voriconazole seems to be effective and safe in the treatment of such cases.
描述一例罕见的界面丝状真菌性角膜炎病例及其成功的临床治疗方法。
回顾性病例报告。分析患者的临床记录。
一名30岁健康女性,主诉视力模糊、畏光和剧痛,此前在准分子原位角膜磨镶术(LASIK)后被诊断为疑似单侧弥漫性板层角膜炎,并因此接受了口服和结膜下皮质类固醇治疗方案。由于症状恶化,患者后来转诊至我们的眼科。检查时,观察到角膜浸润并怀疑有真菌感染。开始使用强化伏立康唑(1%)治疗,并逐渐减少局部和口服皮质类固醇的用量。经过6周的抗真菌局部治疗,浸润消退。在培养基上分离出[此处原文缺失具体分离出的物质]。随访结束时,未矫正的远视力为20/20,有轻度瘢痕形成。
[此处原文缺失具体真菌名称]可能与准分子原位角膜磨镶术后的界面感染有关。当结合早期怀疑、微生物学诊断和适当的保守治疗进行快速干预时,可能会取得良好的结果。此外,伏立康唑在治疗此类病例时似乎有效且安全。