眼部丝状真菌感染的诊断与致病菌分离鉴定

Falimentous Fungal Infection in Eyes and Pathogenic Fungus Identification

目的 分析眼部丝状真菌感染致病菌的种类和致病特征。方法 对 13例眼部丝状真菌感染患者的临床资料进行分析和致病菌分离鉴定 ,对眼部丝状真菌感染的致病菌、发病原因、早期诊断方法、丝状真菌与酵母菌眼部感染特征进行分析。结果 13例患者中 11例为真菌性角膜溃疡 ,2例为真菌性眼内炎 ;13例 15眼标本真菌培养均为丝状真菌 ,其中痂病镰刀菌 3例、尖孢镰刀菌 2例、烟曲霉 2例、谢瓦曲霉 1例、黄曲霉 1例、链格孢霉 1例、尖端单孢子菌 1例、总状毛霉 1例、链霉菌 1例。结论 眼部丝状真菌感染仍以镰刀菌、曲霉为主 ,但有明显的多样化趋势 ;确定诊断须真菌检查 。

OBJECTIVE To find out the fungus and characteristic of pathogenicity about filamentous fungal infection in eyes. METHODS Pathogenic fungi collected from 15 eyes of 13 patients with filamentous fungal infection were isolated for culturing and identification. The patients clinical data were analysed. Pathogenic fungi, pathogenic factors, methods of early diagnosis, feature of infection in eyes of filamentous fungal and yeast were discussed.RESULTS Eleven cases of 13 patients were with filamentous fungal keratitis, two cases were with filamentous fungal endophthalmitis. Fifteen specimens of eyes from 13 cases were positive when they had been cultured in fungal lab. The fungal species identified included Fusarium solani (3 cases), F. oxysporum (2 cases), Aspergillus fumigatus (2 cases), A. chevalieri (1 case), A. flavus (1 case), Alternaria sp (1 case), Monosporium apiospermum (1 case), Mucor racemosus (1 case), Strepromyces sp (1 case). CONCLUSIONS Fusarium and Aspergillus were main pathogenic filamentous fungi in eyes. sofarvbut with the obvious diversified tendency. Diagnosis has to depend on fungal examination. A correct early diagnosis is the key for proper therapy and improving prognosis.