Concha Del Río Luz Elena, Ramirez-Dominguez Carolina, Vanzzini-Zago Virginia, Arellanes-Garcia Lourdes
Inflammatory Eye Diseases Clinic, Hospital Dr. Luis Sánchez Bulnes, Asociación Para Evitar La Ceguera En México, Mexico City, Mexico.
Department of Microbiology, Hospital Dr. Luis Sánchez Bulnes, Asociación Para Evitar La Ceguera En México, Mexico City, Mexico.
Taiwan J Ophthalmol. 2020 Apr 27;11(2):190-192. doi: 10.4103/tjo.tjo_17_19. eCollection 2021 Apr-Jun.
We report a case of sclerokeratouveitis with an unfavorable response to treatment. To the best of our knowledge, there are no previous reports of this fungus invading the sclera. A 68-year-old diabetic farmer male patient presented with a 3-week history of pain and redness and a decrease in visual acuity occurring 5 days before admittance in the right eye. Examination revealed severe mixed hyperemia and a scleral calcified plaque with a surrounding area of ischemia and lysis. The cornea showed diffuse infiltrates, stromal edema, and hypopyon. Initial scrapings were negative, and empiric antibiotics were started. After a fungus was reported, topical and systemic antifungals were initiated, but there was no clinical response. The eye was enucleated. A slow-growing fungus , resistant to voriconazole, was isolated. Fungal etiology must be kept in mind when dealing with infectious scleritis. Despite treatment, the outcome of this case was unfavorable due to the slow-growing nature of the fungus and this strain's resistance to voriconazole.
我们报告一例巩膜角膜葡萄膜炎,其治疗效果不佳。据我们所知,此前尚无该真菌侵袭巩膜的报道。一名68岁的男性糖尿病农民患者,右眼出现疼痛、发红3周病史,入院前5天视力下降。检查发现严重的混合性充血以及一个巩膜钙化斑块,周围有缺血和溶解区域。角膜表现为弥漫性浸润、基质水肿和前房积脓。最初的刮片检查为阴性,遂开始经验性使用抗生素。报告发现真菌后,开始局部和全身使用抗真菌药物,但无临床反应。该眼被摘除。分离出一种生长缓慢、对伏立康唑耐药的真菌。在处理感染性巩膜炎时,必须考虑真菌病因。尽管进行了治疗,但由于该真菌生长缓慢且对伏立康唑耐药,本病例的预后不佳。