Su Qing, Dong He, Cui Lin, Zhang Lijun
Liaoning Provincial Key Laboratory of Cornea and Ocular Surface Diseases, Liaoning Provincial Optometry Technology Engineering Research Center, The Third People's Hospital of Dalian, Dalian Municipal Eye Hospital, Dalian Municipal Cancer Hospital, No. 40, Qianshan Road, Ganjingzi District, Dalian, Liaoning, China.
BMC Infect Dis. 2025 Jan 16;25(1):71. doi: 10.1186/s12879-025-10467-8.
Conjunctival sporotrichosis is a rare fungal infection, typically presenting as granulomatous lesions. Its manifestations can be atypical, particularly in immunosuppressed patients. Here, we present a rare case of a Mooren's ulcer patient with bulbar conjunctival Sporotrichosis presenting as a salmon-pink tumor.
A 61-year-old with a history of Mooren's ulcer and corneal transplantation was diagnosed with conjunctival Sporotrichosis in the left eye. Slit-lamp examination showed conjunctival congestion and edema with a salmon-pink appearance, accompanied by nodules looking like "bread crumbs" scattered under the conjunctiva. After partial tumor resection, histopathology and immunofluorescence staining suggested fungal infection with squamous epithelial hyperplasia. Microbiological testing (DNA) confirmed Sporothrix schenckii as the pathogen. The conjunctival mass resolved without recurrence after local and systemic anti-fungal medicine treatment. Despite the progression of Mooren's ulcers, which further dissolved and perforated during treatment, aggressive management helped the patient retain some vision.
Immunosuppression, such as steroids and tacrolimus eyedrops, may predispose patients to opportunistic infections like sporotrichosis. Oral itraconazole, combined with subconjunctival and topical antifungal therapy, effectively treat severe Sporothrix conjunctivitis. Future studies should explore the balance between antifungal and immunosuppressive therapies to manage coexisting conditions like Mooren's ulcer while curing fungal infections.
结膜孢子丝菌病是一种罕见的真菌感染，通常表现为肉芽肿性病变。其表现可能不典型，尤其是在免疫抑制患者中。在此，我们报告一例罕见病例，一名蚕食性角膜溃疡患者合并球结膜孢子丝菌病，表现为鲑鱼粉红色肿物。
一名61岁有蚕食性角膜溃疡和角膜移植病史的患者被诊断为左眼结膜孢子丝菌病。裂隙灯检查显示结膜充血、水肿，呈鲑鱼粉红色外观，伴有散在的结膜下“面包屑”样结节。部分肿物切除后，组织病理学和免疫荧光染色提示真菌感染伴鳞状上皮增生。微生物检测（DNA）证实病原菌为申克孢子丝菌。局部和全身抗真菌药物治疗后，结膜肿物消退，未复发。尽管蚕食性角膜溃疡病情进展，在治疗期间进一步溶解和穿孔，但积极的治疗帮助患者保留了部分视力。
免疫抑制，如使用类固醇和他克莫司滴眼液，可能使患者易患孢子丝菌病等机会性感染。口服伊曲康唑联合结膜下和局部抗真菌治疗可有效治疗严重的孢子丝菌性结膜炎。未来的研究应探索抗真菌治疗和免疫抑制治疗之间的平衡，以在治愈真菌感染的同时管理蚕食性角膜溃疡等并存疾病。
