刚毛黑孢壳菌感染致真菌性角膜炎1例

A case of fungal keratitis caused by Petriella setifera infection

患者为66岁男性,右眼被木板崩伤后眼红伴视物不清、畏光、流泪,抗炎治疗效果不佳。右眼角膜中央可见4 mm×4 mm大小浸润灶伴表面白色苔被附着。角膜刮片显微镜检查、真菌培养及活体共聚焦显微镜检查均提示真菌感染。分离菌株经过镜下形态鉴定为尖端赛多孢霉,通过基因测序鉴定为刚毛黑孢壳菌。门诊给予角膜清创联合常规抗炎抗真菌治疗,随访期间病情持续好转,初诊40 d后复诊时裂隙灯显微镜检查发现角膜基质变薄,上皮基本愈合,裸眼视力由0.3提高到0.6。

The patient,a 66-year-old male,suffered from redness,blurred vision,photophobia,and tearing in the right eye after being injured by a wooden board.Anti-inflammatory treatment showed poor effectiveness.A 4 mm×4 mm infiltrate with white deposits on the surface was observed in the central cornea of the right eye.Microscopic examination of corneal scrapings,fungal culture,and in vivo confocal microscopy all indicated fungal infection.The isolated strain was identified as Scedosporium apiospermum through microscopic morphology and confirmed as Petriella setifera by gene sequencing.The patient received corneal debridement combined with routine anti-inflammatory and antifungal treatment in the outpatient clinic.During the follow-up period,the condition continued to improve.Slit lamp examination at the revisit 40 days after the initial diagnosis revealed thinning of the corneal stroma,basic healing of the epithelium,and an increase in uncorrected visual acuity from 0.3 to 0.6.