Endophthalmitis Following Cataract Surgery Associated with Atopic Dermatitis-A Case Report

白內障術後之眼內炎與異位性皮膚炎的關聯－病例報告

鄭慧敏(Wai-Man Cheang) ； 沈應誠(Ying-Cheng Shen) ； 魏利真(Li-Chen Wei) ； 王俊元(Chun-Yuan Wang)

《中華民國眼科醫學會雜誌》 53卷1期 (2014/04) Pp. 60-64

https://doi.org/10.30048/ACTASOS.201404_53(1).0010

摘要

目的：描述一位患者白內障術後之眼內炎與異位性皮膚炎的關聯。方法：病例報告。結果：一位28歲男性，右眼白內障接受超音波乳化術及人工水晶體置入手術治療。術前予以Povidone-Iodine消毒，手術過程順利。手術一週後病患主訴右眼視力模糊，經檢查後診斷為右眼眼內炎。前房液及玻璃體培養結果發現Malazessia furfur和Staphylcocus aureus。經過2次玻璃體內抗生素注射、6次前房抗生素注射、人工水晶體移除及前房fungal balls清除手術後，病患病況改善，最佳矯正視力為6/10。結論：此病例顯示異位性皮膚炎病患於白內障術後發生眼內炎時，黴菌感染需列入其致病菌之鑑別診斷，儘早診斷及給予積極治療能改善病患的視力預後。

並列摘要

Purpose: To report a case of endophthalmitis following cataract surgery associated with atopic dermatitis. Methods: Case report. Results: We report a case of exogenous endophthalmitis following an uneventful phacoemulsification in a 28 year-old patient with atopic dermatitis. The aqueous humor and vitreous culture showed Malazessia furfur and Staphylcocus aureus. Intravitreal injection of vancomycin and ceftazidime was performed twice for bacterial endophthalmitis and intracameral injections of voriconazole were given in addition to the debridement of fungal balls and removal of IOL in managing fungal infection. The inflammation in the anterior chamber cleared within two weeks, and best-corrected visual acuity improved to 6/10 two months after phacoemulsification. Conclusions: The current case demonstrates fungal organisms should be considered in the differential diagnosis of endophthalmitis following cataract surgery in patients with atopic dermatitis. Early diagnosis and treatment may improve the outcome in patients with endophthalmitis.

並列關鍵字

atopic dermatitis ； cataract surgery ； endophthalmitis