Louie T, el Baba F, Shulman M, Jimenez-Lucho V
Medical Service, Northport Veterans Affairs Medical Center, New York 11768.
Clin Infect Dis. 1994 Apr;18(4):585-8. doi: 10.1093/clinids/18.4.585.
Endogenous fungal endophthalmitis is being increasingly recognized in susceptible individuals. We report a case of endogenous endophthalmitis due to Fusarium solani that occurred as the sole clinical manifestation of fungal disease in an immunocompromised host. Four previously reported cases of endogenous fusarial endophthalmitis are also reviewed. Two of these patients had no underlying disease and presented with isolated endophthalmitis, while two other patients had acute leukemia and presented with multiple organ involvement due to Fusarium. All three patients with leukemia, including our patient, were severely neutropenic at the time of diagnosis. Two of these three patients had fungemia. MICs of amphotericin B for fungal isolates ranged from 0.14 to 10 micrograms/mL. Despite abatement of the endophthalmitis after antifungal therapy and vitrectomy, the prognosis for immunocompromised patients remains guarded because of underlying disease.
内源性真菌性眼内炎在易感个体中越来越受到关注。我们报告了一例由茄病镰刀菌引起的内源性眼内炎病例，该病例是免疫功能低下宿主中真菌病的唯一临床表现。我们还回顾了之前报道的4例内源性镰刀菌性眼内炎病例。其中2例患者无基础疾病，仅表现为孤立性眼内炎，另外2例患者患有急性白血病，因镰刀菌感染出现多器官受累。包括我们的患者在内，所有3例白血病患者在诊断时均严重中性粒细胞减少。这3例患者中有2例发生真菌血症。两性霉素B对真菌分离株的最低抑菌浓度为0.14至10微克/毫升。尽管抗真菌治疗和玻璃体切除术后眼内炎得到缓解，但由于存在基础疾病，免疫功能低下患者的预后仍不容乐观。
