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通过多次角膜刮片诊断出的黄瓜弯孢霉引起的真菌性角膜炎罕见病例:病例报告

A Rare Case of Fungal Keratitis Caused by Plectosphaerella cucumerina Diagnosed With Repeated Corneal Scrapings: A Case Report.

作者信息

Kiriyama Takuya, Hariya Takehiro, Yoshida Masaaki, Todokoro Daisuke, Nakazawa Toru

机构信息

Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, JPN.

Department of Ophthalmology, Gunma University, Graduate School of Medicine, Maebashi, JPN.

出版信息

Cureus. 2022 Aug 3;14(8):e27628. doi: 10.7759/cureus.27628. eCollection 2022 Aug.

Abstract

is a filamentous fungus that infects plants and crops, but there are few previous reports of human infections. The current case was an 82-year-old woman who was referred to us for corneal infection in her left eye that did not improve with antibacterial and anti-inflammatory treatment. The best-corrected visual acuity (BCVA) of the eye at the first visit to us was hand motion. Slit-lamp examination revealed extensive white infiltration and ulceration in the anterior corneal stroma of the left eye. Intensive antibacterial and antiviral treatment for one month did not improve the condition of the cornea. Although initial culture testing and polymerase chain reaction (PCR) testing of corneal scraping samples did not reveal the causative microorganism, repeated culture testing identified The corneal infection eventually subsided after topical and systemic treatment with voriconazole (VRCZ). The final BCVA in the left eye was 1.3 logMAR. This was a rare case of fungal keratitis due to Our case suggests that it is important to perform repeated examinations with corneal scrapings, especially when the treatment response is poor.

摘要

是一种感染植物和农作物的丝状真菌,但此前关于人类感染的报道很少。当前病例是一名82岁女性,因左眼角膜感染被转诊至我院,经抗菌和抗炎治疗后病情未改善。初次来我院就诊时该眼的最佳矫正视力(BCVA)为手动。裂隙灯检查显示左眼角膜前基质有广泛的白色浸润和溃疡。强化抗菌和抗病毒治疗1个月后角膜状况未改善。虽然角膜刮片样本的初始培养检测和聚合酶链反应(PCR)检测未发现致病微生物,但重复培养检测鉴定出……经伏立康唑(VRCZ)局部和全身治疗后,角膜感染最终消退。左眼最终的BCVA为1.3 logMAR。这是一例罕见的由……引起的真菌性角膜炎病例。我们的病例表明,对角膜刮片进行反复检查很重要,尤其是在治疗反应不佳时。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1133/9437864/5fbf1c320f89/cureus-0014-00000027628-i01.jpg

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