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真菌性角膜炎使角膜炎的诊断复杂化。

Fungal keratitis complicating the diagnosis of keratitis.

作者信息

Atighehchian Mehrnaz, Latifi Alireza, Nozarian Zohreh, Amoli Fahimeh Asadi, Zarei-Ghanavati Mehran

机构信息

Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Med Mycol Case Rep. 2024 Dec 7;47:100687. doi: 10.1016/j.mmcr.2024.100687. eCollection 2025 Mar.

Abstract

A 42-year-old woman was referred to an emergency department. She had an unresponsive corneal ulcer that was initially diagnosed as virus keratitis. Later, the microbiological studies revealed fungal keratitis. Although the patient was given topical antifungal medication, the clinical presentation did not support improvement. Despite using antifungal medication, the infiltration continued to progress, and the patient underwent therapeutic penetrating keratoplasty (T-PKP). Corneal tissue was collected and sent for histopathologic and molecular examination. The results revealed the presence of both T4 subgroup and sp. This case emphasizes the importance of considering infection in progressive and non-responsive infectious keratitis, especially fungal specimens. Polymerase chain reaction (PCR) is an appropriate laboratory molecular diagnostic test for accurate diagnosis keratitis.

摘要

一名42岁女性被转诊至急诊科。她患有角膜溃疡且无反应,最初被诊断为病毒性角膜炎。后来,微生物学研究显示为真菌性角膜炎。尽管给予了患者局部抗真菌药物治疗,但临床表现并未显示病情好转。尽管使用了抗真菌药物,浸润仍在继续进展,患者接受了治疗性穿透性角膜移植术(T-PKP)。采集了角膜组织并送去进行组织病理学和分子检查。结果显示存在T4亚组和sp。该病例强调了在进行性和无反应性感染性角膜炎中考虑感染的重要性,尤其是真菌标本。聚合酶链反应(PCR)是用于准确诊断角膜炎的合适实验室分子诊断测试。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/336f/11729674/f2fee3754784/gr1.jpg

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