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拟青霉属真菌性角膜炎酷似角膜铁锈残渣:一例报告

Phaeoisaria sp. fungal keratitis resembling corneal rust residue: a case report.

作者信息

Zhao YingHan, Zhang MengYao, Hong Jing, Li YingYu, Zhang Pei, Peng RongMei

机构信息

Department of Ophthalmology, Peking University Third Hospital, Beijing, China.

Key Laboratory of Vision Loss and Restoration, Peking University Third Hospital, Beijing, China.

出版信息

BMC Ophthalmol. 2025 Jan 27;25(1):49. doi: 10.1186/s12886-025-03853-y.

Abstract

BACKGROUND

Fungal keratitis can develop after plant injury or after prolonged glucocorticoid use. Typical manifestations include corneal infiltrates, satellite lesions, plaques, and an immune ring. Some cases exhibit atypical signs, requiring reliance on etiological examination. Notably, fungi previously deemed nonpathogenic to humans can cause keratitis with rare clinical manifestations. This report details the clinical signs and successful treatment outcomes of keratitis caused by Phaeoisaria sp.

CASE PRESENTATION

A 51-year-old man visited the ophthalmology clinic with ongoing eye pain and a history of corneal iron foreign body removal two months earlier. Examination revealed a brownish ulcer with clear borders, swelling, and redness, indicating the presence of rust. Although the initial cultures were negative, a rare fungus called Phaeoisaria sp. was eventually identified as causative agent. The patient completed six weeks of antifungal treatment and showed no signs of recurrence at the 7-month follow-up visit.

CONCLUSIONS

Patients with a history of corneal foreign bodies should also be informed of the possibility of atypical corneal fungal infection.

摘要

背景

真菌性角膜炎可在植物性眼外伤后或长期使用糖皮质激素后发生。典型表现包括角膜浸润、卫星灶、斑块及免疫环。部分病例表现为非典型体征,需依靠病原学检查。值得注意的是,一些以往被认为对人类无致病性的真菌可引起临床表现罕见的角膜炎。本报告详细介绍了由拟茎点霉属真菌引起的角膜炎的临床体征及成功治疗结果。

病例介绍

一名51岁男性因持续眼痛就诊于眼科门诊,其两个月前有角膜铁异物取出史。检查发现边界清晰的褐色溃疡,伴有肿胀和充血,提示有铁锈存在。尽管最初的培养结果为阴性,但最终鉴定出一种名为拟茎点霉属的罕见真菌为病原体。患者完成了六周的抗真菌治疗,在7个月的随访中未出现复发迹象。

结论

有角膜异物史的患者也应被告知发生非典型角膜真菌感染的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59a0/11770898/9dd19fbd0011/12886_2025_3853_Fig1_HTML.jpg

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