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胎儿减胎术后患者发生内源性真菌性眼内炎并文献复习:一例病例报告

Endogenous Fungal Endophthalmitis in a Patient After Fetal Reduction Surgery With a Literature Review: A Case Report.

作者信息

Cao Xiaolu, Jia Peipei, Zhao Lili, Qiao Xiulian, Duan Yu, Jia Junxiao, Xin Jiangbo

机构信息

Hebei Ophthalmology Key Lab, Hebei Eye Hospital, Xingtai, Hebei, People's Republic of China.

Department of Pharmacy, First Hospital of Qinhuangda, Qinhuangdao, Hebei, People's Republic of China.

出版信息

Infect Drug Resist. 2025 Mar 15;18:1465-1470. doi: 10.2147/IDR.S497721. eCollection 2025.

DOI:10.2147/IDR.S497721
PMID:40115545
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11922776/
Abstract

Endogenous fungal endophthalmitis (EFE) is a rare but severe ophthalmic emergency that often results in vision-threatening complications and, in extreme cases, can be life-threatening. This report presents a successfully treated case of fungal endophthalmitis, offering insights into clinical management. A 35-year-old female experienced decreased vision in her right eye following fetal reduction surgery. Her best-corrected visual acuity was limited to 10 cm finger counting in the affected eye. Following systemic antifungal therapy combined with vitrectomy, her vision recovered significantly. Through a detailed case analysis and literature review, this study aims to guide clinical practice. In patients with suspected EFE, obtaining early vitreous samples for pathogen identification and initiating timely treatment is critical. Furthermore, early vitrectomy during disease progression, along with an appropriate dosage and duration of antifungal therapy, is essential for restoring visual function and preventing vision loss.

摘要

内源性真菌性眼内炎(EFE)是一种罕见但严重的眼科急症,常导致视力威胁性并发症,在极端情况下可危及生命。本报告介绍了一例成功治疗的真菌性眼内炎病例,为临床管理提供了见解。一名35岁女性在减胎手术后右眼视力下降。患眼最佳矫正视力仅为10厘米手指计数。经过全身抗真菌治疗联合玻璃体切除术后,她的视力显著恢复。通过详细的病例分析和文献回顾,本研究旨在指导临床实践。对于疑似EFE的患者,尽早获取玻璃体样本进行病原体鉴定并及时开始治疗至关重要。此外,在疾病进展期间尽早进行玻璃体切除术,以及给予适当剂量和疗程的抗真菌治疗,对于恢复视功能和预防视力丧失至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e275/11922776/e5c874d4faa3/IDR-18-1465-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e275/11922776/ed7681382732/IDR-18-1465-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e275/11922776/7a791f16e60e/IDR-18-1465-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e275/11922776/e5c874d4faa3/IDR-18-1465-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e275/11922776/ed7681382732/IDR-18-1465-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e275/11922776/7a791f16e60e/IDR-18-1465-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e275/11922776/e5c874d4faa3/IDR-18-1465-g0003.jpg

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本文引用的文献

1
Bilateral endogenous fungal endophthalmitis: A case report.双侧内源性真菌性眼内炎:病例报告。
Medicine (Baltimore). 2023 Apr 21;102(16):e33585. doi: 10.1097/MD.0000000000033585.
2
Endogenous Fungal Endophthalmitis: Causative Organisms, Treatments, and Visual Outcomes.内源性真菌性眼内炎:致病微生物、治疗方法及视力预后
J Fungi (Basel). 2022 Jun 16;8(6):641. doi: 10.3390/jof8060641.
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The Diagnosis and Treatment of Fungal Endophthalmitis: An Update.真菌性眼内炎的诊断与治疗:最新进展
Diagnostics (Basel). 2022 Mar 10;12(3):679. doi: 10.3390/diagnostics12030679.
4
Endogenous Endophthalmitis-The Clinical Significance of the Primary Source of Infection.内源性眼内炎——感染原发灶的临床意义
J Clin Med. 2022 Feb 23;11(5):1183. doi: 10.3390/jcm11051183.
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Understanding the science of fungal endophthalmitis - AIOS 2021 Sengamedu Srinivas Badrinath Endowment Lecture.了解真菌性眼内炎的科学——2021 年 AIOS Sengamedu Srinivas Badrinath 捐赠讲座。
Indian J Ophthalmol. 2022 Mar;70(3):768-777. doi: 10.4103/ijo.IJO_2329_21.
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METAGENOMIC NEXT-GENERATION SEQUENCING DETECTS PATHOGENS IN ENDOPHTHALMITIS PATIENTS.宏基因组下一代测序检测眼内炎患者的病原体。
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Fungal Endophthalmitis: A Comprehensive Review.真菌性眼内炎:全面综述
J Fungi (Basel). 2021 Nov 22;7(11):996. doi: 10.3390/jof7110996.
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Fungal Endophthalmitis: Analysis of 730 Consecutive Eyes from 7 Tertiary Eye Care Centers in India.真菌性眼内炎:来自印度7家三级眼科护理中心的730例连续病例分析。
Ophthalmol Retina. 2022 Mar;6(3):243-251. doi: 10.1016/j.oret.2021.09.006. Epub 2021 Sep 20.
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Endogenous Candida endophthalmitis: Who is really at risk?内源性眼内白色念珠菌感染:谁是真正的高危人群?
J Infect. 2021 Feb;82(2):276-281. doi: 10.1016/j.jinf.2020.12.032. Epub 2021 Jan 4.
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Prevalence and risk factors for endogenous fungal endophthalmitis in adult patients with candidemia at a tertiary care hospital in the Republic of Korea over 13 years.韩国一家三级保健医院 13 年来成年念珠菌血症患者内源性真菌性眼内炎的患病率和危险因素。
J Mycol Med. 2021 Mar;31(1):101102. doi: 10.1016/j.mycmed.2020.101102. Epub 2020 Dec 1.