Ainbinder D J, Parmley V C, Mader T H, Nelson M L
Madigan Army Medical Center, Department of Ophthalmology, Tacoma, WA 98431, USA.
Am J Ophthalmol. 1998 May;125(5):723-5. doi: 10.1016/s0002-9394(98)00024-5.
To describe the manifestations of infectious crystalline keratopathy caused by Candida guilliermondii in a corneal transplant performed for pseudophakic bullous keratopathy.
Case report.
Candida guilliermondii was identified as the causative organism of an indolent infectious crystalline keratopathy. Incisional lamellar biopsy provided diagnostic culture and histopathologic results. Histopathology showed aggregates of yeast elements between corneal stromal lamellae, without inflammation. The infection progressed despite a 6-week course of topical amphotericin B and an additional 6-week course of topical and oral fluconazole. Repeat penetrating keratoplasty resulted in clear graft, with no recurrent infection.
Fungal keratopathy should be included in the differential diagnosis of infectious crystalline keratopathy. Numerous Candida species have been isolated in addition to the most common causative bacterial organism, Streptococcus viridans. Candida guilliermondii is yet one more causative agent of infectious crystalline keratopathy. Candida guilliermondii, a rare human pathogen, was resistant to medical therapy in this case.
描述在为假晶状体大疱性角膜病变进行的角膜移植手术中，季也蒙念珠菌引起的感染性结晶状角膜病变的表现。
病例报告。
季也蒙念珠菌被确定为一种惰性感染性结晶状角膜病变的致病微生物。切口层状活检提供了诊断性培养和组织病理学结果。组织病理学显示角膜基质板层之间有酵母成分聚集，无炎症。尽管局部使用两性霉素B治疗6周，并额外局部和口服氟康唑治疗6周，但感染仍进展。再次穿透性角膜移植术后植片透明，无感染复发。
真菌性角膜病变应列入感染性结晶状角膜病变的鉴别诊断中。除了最常见的致病细菌——草绿色链球菌外，还分离出了多种念珠菌。季也蒙念珠菌是感染性结晶状角膜病变的又一病原体。季也蒙念珠菌是一种罕见的人类病原体，在本病例中对药物治疗耐药。
