Endogenous Aeromonas Hydrophila Endophthalmitis

產氣單胞桿菌引起之內源性眼内炎

周兆峰(Siu-Fung Chau) ； 陳宥蓁(Yu-Chen Chen) ； 蔡顯揚(Hin-Yeung Choi)

《中華民國眼科醫學會雜誌》 51卷1期 (2012/03) Pp. 95-100

https://doi.org/10.30048/ACTASOS.201203.0014

摘要

目的：一位健康的年輕男性因產氣單胞桿菌引起之內源性眼內炎的病例報告。方法：病例報告。結果：一位33歲年輕農夫主訴右眼眼睛疼痛及視力喪失已5天。一周前，他的右手手指在工作時被植物的刺穿刺後造成局部性的蜂窩性組織炎。兩天後，右眼逐漸模糊及疼痛。他表示無眼球外傷及手術之病史。到急診後眼科檢查發現右眼視力為光感，眼壓增高，嚴重的角膜水腫及嚴重的前房反應和積膿。眼部電腦斷層發現右眼球下方有一膨出部位，疑似眼窩下膿瘍。因懷疑是急性眼內炎合併眼窩膿瘍，所以進行緊急眼窩切開引流膿瘍，抽取眼球內液體培養及眼內抗生素注射。眼內抽取液體之培養為產氣單胞桿菌。經手術及靜脈抗生素注射治療後出院。結論：健康的年輕患者因產氣單胞桿菌引起的內源性眼內炎是罕見的，患者的病程會急速惡化，儘管能及時診斷和處理，預後仍然不佳。

並列摘要

Purpose: To report a case of endogenous Aeromonas hydrophila endophthalmitis in a healthy young patient.Methods: Case report.Results: A 33-year-old healthy young farmer suffered from painful sensation and loss of vision in his right eye for 5 days prior to visiting our ER. A week ago, he pricked his finger (right hand) on the thorn of a plant while working and he noted that localized cellulitis developed at the wound site. After two days, progressively blurred vision and pain in his right eye developed. He denied any history of ocular trauma or surgery. An ophthalmic examination of the right eye showed a best-corrected visual acuity of light perception, increased intraocular pressure, severe corneal edema, and severe anterior chamber reaction with hypopyon. CT scan showed focal downward bulging of the right eye without intraocular foreign body. Under the impression of endogenous endophthalmitis complicated with orbital abscess, immediate orbitotomy was performed to drain the abscess and repair the sclera, as well as obtain intraocular cultures samples and inject intravitreal antibiotics. Pain subsided progressively and Aeromonas hydrophila was isolated by intraocular culture.Conclusions: Endogenous endophthalmitis caused by Aeromonas hydrophila in healthy young patients is rare. It has a rapid clinical course and a poor prognosis, despite prompt diagnosis and management.

並列關鍵字

Endogenous endophthalmitis ； Aeromonas hydrophila