UNASSIGNED: A 66-year-old gentleman with a complex right eye (OD) ocular history including herpes simplex virus infectious epithelial keratitis with subsequent neurotrophic keratopathy, and prior combined Candida albicans and parapsilosis fungal keratitis presented with pain OD in the absence of an antecedent trauma. The patient was found to have a filamentous fungal keratitis, which was subsequently cultured and identified as Phialophora chinensis by the laboratory. Despite topical and oral antifungal treatment based on sensitivities determined by the lab, the patient ultimately required intrastromal and subconjunctival antifungal injections, corneal crosslinking, and superficial keratectomy with amniotic membrane to clinically improve. The fungal keratitis recurred twice, with each occurrence rapidly progressing to corneal perforation. Months after the second penetrating keratoplasty, the patient\'s mental status declined due to multiorgan failure. An occult pulmonary malignancy was discovered during this hospital stay, and the patient was lost to follow-up after entering hospice.
UNASSIGNED: We report a unique case of fungal keratitis caused by Phialophora chinensis and the subsequent management, including both medical and surgical interventions. Despite a multimodal treatment regimen, this case demonstrates the recalcitrant and potentially recurrent nature of fungal keratitis caused by P. chinensis.
UNASSIGNED:一位66岁的绅士,拥有复杂的右眼(OD)眼部病史,包括单纯疱疹病毒感染性上皮性角膜炎并随后发生神经营养性角膜病变,和先前合并的白色念珠菌和近apsilioma真菌性角膜炎在没有先前创伤的情况下表现为疼痛OD。病人被发现有丝状真菌性角膜炎,随后被实验室培养并鉴定为Phialophorachinensis。尽管根据实验室确定的敏感性进行了局部和口服抗真菌治疗,患者最终需要在基质内和结膜下注射抗真菌药物,角膜交联,和浅表角膜切除术与羊膜的临床改善。真菌性角膜炎复发两次,每次发生迅速进展为角膜穿孔。第二次穿透性角膜移植术后的几个月,患者的精神状态因多器官功能衰竭而下降。在住院期间发现了隐匿性肺部恶性肿瘤,患者在进入临终关怀医院后失去了随访。
UNASSIGNED:我们报告了一例由中华phialophora引起的真菌性角膜炎的独特病例以及随后的治疗方法,包括医疗和手术干预。尽管采用了多模式治疗方案,该病例显示了由中国黄曲霉引起的真菌性角膜炎的顽固性和潜在复发性。