論文 - 詳細
| RRC ID | 52805 |
|---|---|
| 著者 | Hotta F, Eguchi H, Nishimura K, Kogiso M, Ishimaru M, Kusaka S, Shimomura Y, Yaguchi T. |
| タイトル | A super-infection in the cornea caused by Stemphylium, Acremonium, and α-Streptococcus. |
| ジャーナル | Ann Clin Microbiol Antimicrob |
| Abstract |
BACKGROUND:Polymicrobial keratitis with fungus and bacteria can lead to blindness and is challenging to treat. Here, we introduce a case of fungal keratitis caused by two different strains in addition to definite bacterial super-infection caused by an α-Streptococcus sp., and describe the importance of microscopic examination. CASE PRESENTATION:A 74-year-old woman, who had a past history of infection with leprosy, presented with conjunctival hyperaemia, pain, and corneal opacity in her right eye. Under the presumptive diagnosis of infectious keratitis, corneal scrapings were stained by various reagents and inoculated on several agar plates. Microscopic findings of the scrapings revealed fungi and a small number of Gram-positive cocci. Multiple anti-fungal therapies with levofloxacin ophthalmic solution were administered. Although empiric treatment was initially effective, keratitis recurred 10 days after its initiation. Repeated corneal scraping revealed an abundance of Gram-positive chain cocci and a small amount of fungi, resulting in the switching of an antibiotic medication from levofloxacin to moxifloxacin and cefmenoxime. Keratitis resolved gradually after the conversion. Stemphylium sp., Acremonium sp., and α-Streptococcus sp. were simultaneously isolated from the corneal scrapings. CONCLUSIONS:To the best of our knowledge, this is the first case of fungal keratitis caused by Stemphylium sp., and also the first case of super-infection in the cornea caused by two different fungi and one bacterium. Microscopic examination of the corneal scrapings was beneficial in rapid decision of changing to appropriate drug according to the dominancy of pathogenicity. |
| 巻・号 | 16(1) |
| ページ | 11 |
| 公開日 | 2017-3-9 |
| DOI | 10.1186/s12941-017-0187-z |
| PII | 10.1186/s12941-017-0187-z |
| PMID | 28279173 |
| PMC | PMC5345249 |
| MeSH | Acremonium / drug effects Acremonium / growth & development* Acremonium / pathogenicity Aged Anti-Infective Agents / therapeutic use Cefmenoxime / therapeutic use Coinfection / diagnosis* Coinfection / drug therapy Coinfection / microbiology Coinfection / pathology Cornea / drug effects Cornea / microbiology Cornea / pathology Eye Infections, Fungal / diagnosis* Eye Infections, Fungal / drug therapy Eye Infections, Fungal / microbiology Eye Infections, Fungal / pathology Female Fluoroquinolones / therapeutic use Humans Keratitis / diagnosis* Keratitis / drug therapy Keratitis / microbiology Keratitis / pathology Levofloxacin / therapeutic use Moxifloxacin Saccharomycetales / drug effects Saccharomycetales / growth & development* Saccharomycetales / pathogenicity Streptococcus / drug effects Streptococcus / growth & development* Streptococcus / pathogenicity |
| IF | 3.155 |
| 引用数 | 3 |
| リソース情報 | |
| 病原真核微生物 | 病原真菌：IFM 63142, IFM 63228, IFM63143, IFM 63227 |