微孢子虫感染性角膜炎1例  

A case of microsporidial keratitis

作　　者：张莉 杜满 李鹏 齐洪梅 郭晓婷 鹿秀海 Zhang Li;Du Man;Li Peng;Qi Hongmei;Guo Xiaoting;Lu Xiuhai(Eye Institute of Shandong First Medical University,Eye Hospital of Shandong First Medical University(Shandong Eye Hospital),State Key Laboratory Cultivation Base,Shandong Provincial Key Laboratory of Ophthalmology,School of Ophthalmology,Shandong First Medical University,Jinan 250021,China)

机构地区：[1]山东第一医科大学附属眼科研究所,山东第一医科大学附属眼科医院(山东省眼科医院)山东省眼科学重点实验室-省部共建国家重点实验室培育基地山东第一医科大学眼科学院,济南250021

出　　处：《中华眼科杂志》2022年第11期942-945,共4页Chinese Journal of Ophthalmology

基　　金：山东省医学科学院院级项目(2018-20)。

摘　　要：患者女性, 57岁, 无诱因左眼眼红、眼磨伴视力下降病史1年。2个月前初诊为病毒性角膜炎, 按病毒性角膜炎治疗2个月后病情加重, 角膜出现溃疡。行角膜刮片细胞学检查, 角膜刮片行荧光染色可见较多蓝色椭圆形孢子样结构, 行齐-内染色可见较多红色椭圆形孢子样结构, 确诊为左眼微孢子虫性角膜炎。局部给予氧氟沙星眼膏、伏立康唑滴眼液等抗炎抗感染治疗效果不佳, 后行穿透性角膜移植术, 术后患者病情平稳。A case of keratitis caused by microsporidia infection was reported.A 57-year-old female patient,without any obvious predisposing cause,presented with eye redness,eye abrasion and vision loss for one year in the left eye.The patient was diagnosed with viral keratitis based on laboratory examinations and clinical symptoms two months ago in our hospital.He was given outpatient treatment for antivirus.Two months later,he was admitted to our hospital with worsened condition that presented with corneal ulcer.After admission,corneal scraping examination was performed for the detection of microsporidia with calcofluor white(CFW)and Ziehl-Neelsen staining,the smear revealed multiple oval spore-like structures,with acid-fast positive and showed blue fluorescence on potassium hydroxide with CFW stain,confirming a diagnosis of microsporidial keratitis in the left eye.Treatment:topical use of ofloxacin eye ointment and voriconazole eye drops was not effective,and then penetrating keratoplasty was performed,and the patient′s condition was stable after surgery.At present,they are still in treatment and follow-up.

关 键 词：微孢子虫病 角膜炎 眼感染 真菌性 着色剂 

分 类 号：R772.21[医药卫生—眼科]