Bartz-Schmidt K U, Tintelnot K, Steffen M, Ozel M, Kirchhof B, Heimann K
Department of Ophthalmology, University of Cologne, Germany.
Graefes Arch Clin Exp Ophthalmol. 1996 Sep;234(9):591-3. doi: 10.1007/BF00448805.
Basidiomycetes are known as rare pathogens for meningitis, sinusitis, pneumonia, ulcerative lesions of the hard palate and onychomycosis. To our knowledge, no filamentous basidiomycete has been reported from a case of fungal endophthalmitis.
We report on a 67-year-old man with delayed-onset endophthalmitis caused by an opportunistic basidiomycete. Tissue obtained during vitrectomy was cultured and examined by light and transmission electron microscopy. After enucleation the eye was examined by light microscopy.
The patient had endophthalmitis from a sterile hyphomycete, harboured in remnants of lens capsule and a granuloma on the ciliary body. It was recognized as a Holobasidiomycete on the basis of its dolipore structure with perforated pore cap, seen with transmission electron microscopy. Species identification was not possible because fruiting bodies were absent. The patient failed to respond to intravitreal and systemic amphotericin B and systemic itraconazole. The eye was enucleated. This case demonstrates that filamentous basidiomycetes can cause endophthalmitis when inoculated during cataract extraction.
担子菌被认为是脑膜炎、鼻窦炎、肺炎、硬腭溃疡性病变和甲癣的罕见病原体。据我们所知，尚未有丝状担子菌引起真菌性眼内炎的病例报道。
我们报告一例67岁男性，由机会性担子菌引起迟发性眼内炎。对玻璃体切割术中获取的组织进行培养，并通过光学显微镜和透射电子显微镜检查。眼球摘除后，通过光学显微镜检查眼球。
患者的眼内炎由一种无菌丝真菌引起，该真菌存在于晶状体囊残余物和睫状体上的肉芽肿中。通过透射电子显微镜观察到其具有带穿孔孔盖的桶孔隔膜结构，据此认定为全担子菌。由于没有子实体，无法进行物种鉴定。患者对玻璃体内及全身应用两性霉素B和全身应用伊曲康唑均无反应。眼球被摘除。该病例表明，丝状担子菌在白内障摘除术中接种时可引起眼内炎。
