Aristimuño B, Nirankari V S, Hemady R K, Rodrigues M M
Department of Ophthalmology, University of Maryland School of Medicine, Baltimore.
Am J Ophthalmol. 1993 Feb 15;115(2):202-8. doi: 10.1016/s0002-9394(14)73924-8.
We studied the occurrence of ulcerative keratitis in five eyes of four patients who were examined at the University of Maryland Hospital ophthalmology clinic over a 12-month period. All were young women who were intravenous drug abusers, with no known predisposing factors for ulcerative keratitis. Two patients had acquired immunodeficiency syndrome (AIDS), one was human immunodeficiency virus (HIV)-positive, and the fourth refused HIV testing. One had a corneoscleral limbus to corneoscleral limbus keratitis; three had inferiorly located corneal ulcers (bilateral in one patient with AIDS). Corneal cultures disclosed Capnocytophaga species in the corneoscleral limbus to corneoscleral limbus keratitis. The remaining ulcers were polymicrobial; cultures of three grew Candida albicans, cultures of two grew alpha-hemolytic streptococci, cultures of two grew Staphylococcus aureus, and culture of one grew Pseudomonas aeruginosa. Treatment with topical fortified antibiotics and antifungal agents resulted in complete healing in all four inferiorly located ulcers. The corneal ulcer became perforated and the eye was eviscerated. Histopathologic analysis of the eviscerated specimen disclosed acute keratitis with necrosis and no microorganisms.
我们研究了在12个月期间于马里兰大学医院眼科诊所接受检查的4名患者的5只眼中溃疡性角膜炎的发生情况。所有患者均为年轻女性，是静脉注射吸毒者，无已知的溃疡性角膜炎诱发因素。两名患者患有获得性免疫缺陷综合征（AIDS），一名为人类免疫缺陷病毒（HIV）阳性，第四名患者拒绝进行HIV检测。一名患者患有从角膜缘到角膜缘的角膜炎；三名患者有位于下方的角膜溃疡（一名AIDS患者为双侧）。角膜培养在从角膜缘到角膜缘的角膜炎中发现了二氧化碳嗜纤维菌属。其余溃疡为混合菌感染；三份培养物中培养出白色念珠菌，两份培养物中培养出甲型溶血性链球菌，两份培养物中培养出金黄色葡萄球菌，一份培养物中培养出铜绿假单胞菌。使用局部强化抗生素和抗真菌药物治疗后，所有四个位于下方的溃疡均完全愈合。角膜溃疡穿孔，眼球被摘除。摘除标本的组织病理学分析显示为伴有坏死的急性角膜炎，未发现微生物。
