Font R L, Jakobiec F A
Arch Ophthalmol. 1976 Sep;94(9):1513-9. doi: 10.1001/archopht.1976.03910040347009.
A middle-aged man had blurred vision, redness, and pain in the right eye. Ophthalmoscopic examination revealed slowly progressive necrotizing retinitis in the peripheral superonasal quadrant. The clinical impression was toxoplasmic retinochoroiditis, but lesions failed to respond to steroids, pyrimethamine, and sulfonamides. The eye was enucleated and, histopathologically, showed necrotizing granulomatous retinochoroiditis and optic neuritis, numerous cigarshaped, yeast-like organisms located within the necrotic retina and subretinally, and a subretinal asteroid body. Organisms were identified as Sporotrichum schenkii by immunofluorescence techniques. Electron microscopical studies of the fungus disclosed an unusually thickened capsule with a well-developed cell wall, the outer portion of which exhibited a radiating pattern of granular filamentous material. The ability of S schenkii to cause endophthalmitis in a patient without apparent primary infection should be remembered in the differential diagnosis of a cryptogenic, slowly progressive intraocular infection.
一名中年男性右眼出现视力模糊、眼红和疼痛。眼底镜检查发现鼻上象限周边部有缓慢进展的坏死性视网膜炎。临床诊断为弓形体性视网膜脉络膜炎，但病变对类固醇、乙胺嘧啶和磺胺类药物无反应。该眼被摘除，组织病理学显示为坏死性肉芽肿性视网膜脉络膜炎和视神经炎，在坏死的视网膜内和视网膜下有许多雪茄状、酵母样生物体，以及一个视网膜下星状体。通过免疫荧光技术鉴定这些生物体为申克孢子丝菌。对该真菌的电子显微镜研究显示其有异常增厚的荚膜和发育良好的细胞壁，细胞壁外部呈现出颗粒状丝状物质的放射状图案。在对原因不明的、缓慢进展的眼内感染进行鉴别诊断时，应记住申克孢子丝菌在无明显原发感染的患者中引起眼内炎的可能性。
