Jones B R, Clayton Y M, Oji E O
Postgrad Med J. 1979 Sep;55(647):625-8. doi: 10.1136/pgmj.55.647.625.
Oculomycosis may be divided into the orbital infections of phycomycosis of and other species and the infections of the globe. The latter comprise endogenous, post-surgical or traumatic intra-ocular infections and direct infections of the cornea: these are the commonest form of oculomycosis. They are not easy to differentiate from other, more common causes of septic infection of the eye. The early recognition of fungal infections of the eye thus rests on maintaining an efficient service for all septic infections of the eye. and other dimorphic fungal infections are best treated with flucytosine combined with either polyenes such as amphotericin B and natamycin or combined with imidazoles such as clotrimazole or miconazole. spp. account for about 50% of the cases of filamentous fungal infection of the cornea but more than 100 species of varying pathogenicity and drug sensitivity have been implicated. Econazole, clotrimazole or miconazole combined with thiabendazole are recommended for spp. Econazole, thiabendazole or miconazole combined with flucytosine for sp. For and other species econazole is the best drug but some isolates are sensitive to thiabendazole or other imidazoles. Alternatively, filamentous fungal infections may be treated with natamycin which has a broad spectrum of activity; but does not penetrate well and, like other polyenes, should not be combined with imidazole antifungal chemotherapy because of antagonistic drug interaction. Overall, econazole emerges as the most widely acting drug; but successful results are dependent on rather complex investigation with intensive and protracted care that can best be provided in a few centres of referral.
眼真菌病可分为眼眶毛霉菌病及其他种类的眼眶感染和眼球感染。后者包括内源性、手术后或外伤性眼内感染以及角膜直接感染：这些是眼真菌病最常见的形式。它们不易与其他更常见的眼部化脓性感染原因相鉴别。因此，早期识别眼部真菌感染依赖于为所有眼部化脓性感染提供高效的诊疗服务。 及其他双相真菌感染最好用氟胞嘧啶联合多烯类药物（如两性霉素B和那他霉素）或联合咪唑类药物（如克霉唑或咪康唑）进行治疗。曲霉菌属约占角膜丝状真菌感染病例的50%，但涉及100多种致病性和药敏性各异的菌种。推荐用益康唑、克霉唑或咪康唑联合噻苯达唑治疗曲霉菌属。用益康唑、噻苯达唑或咪康唑联合氟胞嘧啶治疗镰刀菌属。对于曲霉菌及其他种类，益康唑是最佳药物，但一些分离株对噻苯达唑或其他咪唑类药物敏感。另外，丝状真菌感染可用具有广谱活性的那他霉素治疗；但其穿透性不佳，并且与其他多烯类药物一样，由于药物相互拮抗作用，不应与咪唑类抗真菌化疗药物联合使用。总体而言，益康唑是作用最广泛的药物；但成功的治疗效果依赖于相当复杂的检查以及强化和长期的护理，而这最好在少数几个转诊中心提供。
