Srujana Dubbaka, Shankar Sandeep, Anand Kavita Bala, Agrawal Mohini, Singhal Aanchal, Kumar Ashok, Kochhar Divya
Department of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India.
Department of Microbiology, Armed Forces Medical College, Pune, Maharashtra, India.
Oman J Ophthalmol. 2024 Jun 27;17(2):261-263. doi: 10.4103/ojo.ojo_175_23. eCollection 2024 May-Aug.
keratitis is mostly seen in patients with alcoholism, malnutrition, or HIV. Its chronic waxing-and-waning course makes it difficult to diagnose. A 53-year-old male presented with pain and redness in his right eye for the past 3 weeks. The cornea had paracentral ulcer with stromal infiltrates and multiple satellite lesions giving wreath-like appearance suggestive of . After corneal scraping, fortified amikacin, moxifloxacin, and cycloplegics were started. Gram stain revealed filamentous, branching Gram-positive bacteria and acid-fast on Ziehl-Neelsen stain confirming our clinical diagnosis. Ulcer completely resolved over 6 weeks. Thus, a high index of clinical suspicion which was further backed by microbiological confirmation aided in expedient management ensuring a successful outcome.
角膜炎多见于酗酒、营养不良或感染艾滋病毒的患者。其慢性的病情反复过程使得诊断困难。一名53岁男性在过去3周出现右眼疼痛和发红。角膜有旁中心溃疡伴基质浸润和多个卫星病灶，呈花环样外观，提示……角膜刮片后，开始使用强化阿米卡星、莫西沙星和睫状肌麻痹剂。革兰氏染色显示丝状、分支的革兰氏阳性菌，齐-尼氏染色显示抗酸菌，从而证实了我们的临床诊断。溃疡在6周内完全愈合。因此，高度的临床怀疑加上微生物学确认的支持有助于进行有效的治疗，确保取得成功的结果。
