最近诊断的阿坎萨摩巴角膜炎表现为宫内角膜:一个病例报告
Sepehr Feizi1, Zahra Karjou, Hamed Esfandiari
1Ocular Tissue Engineering Research Center (S.F., Z.K.), Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran; and Department of Ophthalmology (H.E.), Olmsted Medical Center, Rochester, MN.
Eye & contact lens
|September 15, 2023
概括
在隐形眼镜佩戴者中,Acanthamoeba角膜炎是一种严重的眼部感染,可以模仿其他疾病. 使用孔焦显微镜和活检进行早期诊断对于用聚乙烯比古安化物和可纳进行有效治疗至关重要.
科学领域:
- 眼科医生 眼科 眼科
- 传染性疾病 传染性疾病
- 微生物学 微生物学
背景情况:
- 隐形眼镜的佩戴是微生物角膜炎的重要危险因素.
- 对角膜感染的错误诊断可能导致延迟和无效的治疗.
- 阿坎萨摩巴角膜炎呈现出各种临床症状,通常模仿其他角膜病理.
研究的目的:
- 强调在持久角膜透症的隐形眼镜佩戴者中考虑Acanthamoeba感染的重要性.
- 介绍一个Acanthamoeba角膜炎的病例,最初被误诊为简单疹角膜炎和细菌角膜炎.
- 强调共聚焦显微镜和角膜活检的诊断效用.
主要方法:
- 隐形眼镜佩戴者视力下降和眼部不适的临床案例介绍.
- 简单疹角膜炎和细菌角膜的初始诊断和治疗.
- 使用共聚焦显微镜和角膜活检进行最终诊断.
- 用聚乙烯比古安化物和口服基托可纳治疗.
主要成果:
- 患者的症状最初恶化了,尽管对疑似单纯疹角膜炎和细菌角膜炎进行了治疗.
- 同焦点显微镜和角膜活检证实了阿坎萨摩巴菌感染.
- 用聚乙烯比古安化物和可纳治疗导致在10天内临床改善.
- 视觉敏度提高到5/10,在9个月后留下了一个残留的侧叶痕.
结论:
- 应强烈考虑在隐形眼镜佩戴者呈现内侧角膜,特别是当初始治疗失败时,阿坎萨摩巴感染.
- 通过先进的成像和活检进行快速准确的诊断对于成功的管理至关重要.
- 早期干预可以预防来自Acanthamoeba角膜炎的严重视力损伤.
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