Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
Hunan Clinical Research Center of Ophthalmic Disease, Changsha, Hunan, China.
Ocul Immunol Inflamm. 2024 Dec;32(10):2575-2578. doi: 10.1080/09273948.2024.2386736. Epub 2024 Aug 8.
To report a rare case of fungal keratitis caused by , highlighting its unique morphological features using in vivo confocal microscopy (IVCM).
This was a retrospective case report. A 66-year-old man presented with foreign body sensation and blurred vision in his left eye for over 10 months.
His best-corrected visual acuity was 20/20. Slit-lamp examination revealed a gray-white lesion approximately 4-5 mm in the superficial layer of the central cornea without epithelial defects. The IVCM images revealed numerous round or round-like pathogens, each with a central highly reflective body surrounded by a dark ring, ranging in size from 5 to 30 µm, and to a maximum of 85 µm, observed in the corneal epithelium and superficial stroma. No obvious inflammatory cell infiltration was observed in the lesions or endothelium. infection was confirmed. The round pathogens completely disappeared after 8 weeks of treatment with topical amphotericin B and voriconazole eye drops.
Fungal keratitis caused by is rare and easily overlooked due to atypical clinical signs and symptoms. This case reports the unique morphological features of in the cornea using IVCM for the first time, facilitating rapid, noninvasive auxiliary diagnosis of keratitis and treatment follow-up.
报告一例罕见的由 引起的真菌性角膜炎病例，使用活体共聚焦显微镜（IVCM）突出其独特的形态学特征。
这是一项回顾性病例报告。一名 66 岁男性因左眼异物感和视力模糊超过 10 个月就诊。
他的最佳矫正视力为 20/20。裂隙灯检查显示中央角膜浅层约 4-5mm 的灰白色病变，无上皮缺损。IVCM 图像显示在角膜上皮和浅层基质中存在大量圆形或类圆形病原体，每个病原体中央都有一个高度反光的体，周围有一个暗环，大小从 5 到 30μm，最大可达 85μm。病变或内皮无明显炎症细胞浸润。 感染得到确认。经过 8 周的局部两性霉素 B 和伏立康唑滴眼液治疗后，圆形病原体完全消失。
由于不典型的临床症状和体征，由 引起的真菌性角膜炎较为罕见，容易被忽视。本病例首次使用 IVCM 报告了 在角膜中的独特形态学特征，有助于快速、无创辅助诊断 角膜炎并进行治疗随访。
