摘要
目的回顾性分析24例内源性眼内炎的全身易感因素及致病微生物。设计回顾性病例系列。研究对象2009年1月至2013年1月就诊于北京同仁医院确诊为内源性眼内炎的患者24例(32眼)。方法对所有患者进行病史询问、血清免疫学检查如(如RF、HLA-B27等)、常规眼科检查(包括视力、眼压、裂隙灯、间接检眼镜检查等)及眼B型超声检查,对符合手术标准的患者进行玻璃体切除术治疗,术中获取房水、玻璃体进行涂片和培养。主要指标全身易感因素和房水、玻璃体的涂片及培养结果。结果 24例患者中,主要全身病史包括:糖尿病4例(16.7%),手术(引产、胆结石、肾结石)后3例(12.7%),肝脓肿2例(8.4%),连续高强度工作史2例(8.4%),泌尿系统感染2例(8.4%),阴道炎2例(8.4%),长期免疫抑制剂使用1例(4.2%),口腔感染1例(4.2%),细菌性脑膜炎1例(4.2%),呼吸系统感染1例(4.2%)。24例患者中有16例(66.7%)患者在眼部症状出现前或伴随眼部症状出现发热,并接受全身抗生素治疗,有静脉输液史。31眼眼内液培养阳性率为54.8%(17眼),其中45.2%(14眼)为真菌,分别为:白色念珠菌7眼(22.6%),假丝酵母菌3眼(9.7%),西弗假丝酵母菌2眼(6.5%),高里丝假丝酵母菌1眼(3.2%),热带念珠菌1眼(3.2%);9.7%(3眼)为细菌:2眼(6.5%)为肺炎克雷伯杆菌,1眼(3.2%)为浅绿气球菌。结论本组内源性眼内炎患者的全身病史以不同诱因引起的发热多见,常见诱因包括外科手术、泌尿生殖系统感染及肝脓肿,全身基础病变以糖尿病多见。致病微生物以真菌多见,特别是白色念珠菌,细菌以肺炎克雷伯杆菌多见。
Objective To analyze the predisposing factors and pathogenic microorganisms of 24 patients with endogenous endophthalmitis. Design Retrospective case series. Participants 24 patients （32 eyes） with endogenous endophthalmitis from Beijing Tongren Hospital from Jan. 2009 to Jan. 2013. Methods All patients were asked medical histories and routine ophthalmic examinations. Aqueous humor and vitreous specimens were taken by vitrectomy, and were smeared and cultured. Main Outcome Measures Predis -posing factors, the results of intraocular fluid cultivation. Results The main systemic predisposing factors included： diabetes mellitus in 4 cases （16.7%）, surgeries in 3 cases （12.7%）, liver abscess in 2 cases （8.4%）, history of continuous high-strength working in 2 cases（8.4%）, urinary tract infection in 2 cases （8.4%）, vaginitis in 2 cases （8.4%）, long-term use of immunosuppressive agents in 1 case（4.2%）, oral infection in 1 case（4.2%）, bacterial meningitis in 1 cases （4.2%） and respiratory infection in 1 case（4.2%）. Sixteen cases （66.7%） had a fever, and accepted systemic antibiotic treatment with a history of intravenous infusion. The positive rate of intraocular fluid cultivation was 54.8% （17 eyes）. 45.2% （14 eyes） was fungal, especially candida albicans. 9.7% （3 eyes） was bacteria, and 2 eyes （6.5%） of the 3 eyes were pneumonia klebsiella bacillus. Conclusion The main predisposing factors of this group of patients were fever caused by different reasons, and the common causes included surgical operation, genito-urinary system infection and liver abscess. The main systemic disease was diabetes mellitus. The main pathogens were fungi, especially candida. And the main bacteria was pneumonia klebsiella bacillus.
出处
《眼科》
CAS
2014年第3期201-204,共4页
Ophthalmology in China
基金
北京市自然科学基金(7122042)
关键词
眼内炎
易感因素
致病微生物
endophthalmitis
predisposing factors
pathogenic microorganism
