■非液化莫拉氏菌(M.nonliquefaciens)是一种低致病性微生物,很少引起眼部感染,除非有诱发因素.非液化支原体眼部感染的主要临床表现是眼内炎,仅报道了5例角膜感染。这项工作显示了非利口菌角膜感染的最新情况,以及首例报告的由非利口菌重叠感染单纯疱疹感染引起的角膜炎病例。
■一名84岁的单纯疱疹性角膜炎恶化的妇女,诊断,并在2天前治疗。裂隙灯显示出深的近中心浸润和出血性。在开始使用万古霉素和头孢他啶强化的经验性抗生素治疗之前,收集角膜样品进行培养。口服阿昔洛韦,和环戊酸酯。该菌株被鉴定为非液化分枝杆菌,局部抗生素治疗被调整为环丙沙星和头孢他啶。2周后,上皮缺损和浸润得到解决,方案中加入了泼尼松龙.随着角膜水肿和新生血管的减少,阿昔洛韦,强的松龙逐渐变细。大约4个月后,视力结果为20/50,眼科检查显示透明角膜伴中央旁白血病.
■由非液化分枝杆菌引起的角膜炎很少见,在有局部诱发因素如角膜损伤或先前角膜感染的患者中应怀疑。对易感病变和角膜炎及时、适当的联合治疗可以改善预后,避免采取更积极的治疗方法。
UNASSIGNED: Moraxella nonliquefaciens (M. nonliquefaciens) is a low pathogenicity microorganism, which rarely causes ocular infections, unless there is a predisposing factor. The main clinical manifestation of M. nonliquefaciens ocular infections is endophthalmitis and only five cases of corneal infection have been reported. This work shows an update in M. nonliquefaciens corneal infections, and the first reported case of keratitis due to M. nonliquefaciens superinfecting herpes simplex infection.
UNASSIGNED: A 84-year old woman with worsening of her herpes simplex keratitis, diagnosed, and treated 2 days before. The slit lamp showed deep paracentral infiltrate and hypopyon. A corneal sample was collected for culture prior to initiation of empiric antibiotic therapy with vancomycin and ceftazidime fortified, oral acyclovir, and cyclopentolate. The strain was identified as M. nonliquefaciens and topical antibiotic therapy was adjusted to ciprofloxacin and ceftazidime. After 2 weeks, the epithelial defect and the infiltrate were resolved and prednisolone was added to the regimen. As the corneal oedema and neovascularization decreased, acyclovir, and prednisolone were slowly tapered. About 4 months later, the visual outcome was 20/50 and the ophthalmic examination showed a clear cornea with a paracentral leucoma.
UNASSIGNED: Keratitis due to M. nonliquefaciens is rare and should be suspected in patients with local predisposing factors such as corneal damage or previous corneal infection. Prompt and appropriate combined treatment for the predisposing lesions and the keratitis may improve the prognosis and avoid a more aggressive approach.