多重耐药牙龈二氧化碳噬纤维菌性角膜溃疡1例

Corneal ulcer caused by multi-drug resistant Capnocytophaga gingivalis:a case report

目的分析1例牙龈二氧化碳噬纤维菌感染引起的角膜溃疡病例,为该病原菌的分离鉴定和诊断治疗提供经验。方法回顾并分析1例山东中医药大学附属眼科医院收治的牙龈二氧化碳噬纤维菌感染角膜溃疡患者的临床资料、辅助检查结果以及治疗方案。结果患者为61岁女性,因“左眼红痛伴视力下降2月”于2022年9月28日入院,患者角膜溃疡较重,左侧角膜中央有灰白色溃疡灶,直径约10 mm,周围角膜水肿浸润,角膜缘新生血管长入角膜约2 mm。角膜刮取物培养出二氧化碳噬纤维菌属,该菌目前无临床折点,根据体外培养和药敏试验结果,使用全身注射亚胺培南和局部滴眼抗感染治疗,结合角膜羊膜移植术,治疗24 d,患者症状改善后出院。结论结合样本涂片镜检和药敏结果,评估患者病情,及时给予合理治疗,采取有效的手术方法,对改善牙龈二氧化碳噬纤维菌引起的角膜溃疡患者的预后有重要意义。

Objective To analyze a case of corneal ulcer caused by Capnocytophaga gingivalis infection,and to provide experience for the isolation,identification,diagnosis and treatment of this pathogen.Methods The clinical data,auxiliary examination results and treatment plan of a patient with corneal ulcer and Capnocytophaga gingivalis infection admitted to the Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine were reviewed and analyzed.Results The patient was a 61-year-old woman admitted to the hospital on September 28,2022 due to"red pain in left eye with vision loss for 2 months",with severe corneal ulcers.The diameter of gray-white ulcer in the center of left cornea was about 10 mm,the surrounding corneal edema was infiltrate,and the limbal neovascularization grew into cornea about 2 mm.According to the results of in vitro culture and drug susceptibility,the whole body injection of imipenem and local eye drops anti-infection treatment,combined with corneal amniotic membrane transplantation,treatment for 24 days,the symptoms were improved and the patient was discharged.Conclusions Combined with sample smear microscopy and drug susceptibility results,it is of great significance to evaluate the patient's condition,give timely and reasonable treatment,and adopt effective surgical methods to improve the prognosis of corneal ulcers caused by Capnocytophaga gingivalis.