7个月大非医院获得性铜绿假单胞菌性角膜炎

Yanik Keramettin, Hatice Buse Uras, Celal Yeter
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摘要

铜绿假单胞菌是引起细菌性角膜炎并发溃疡的重要病原体之一。在这项研究中,我们评估了一例非医院获得性铜绿假单胞菌角膜炎在一个7个月大的婴儿和其治疗过程。患者没有已知的慢性疾病,因左眼流泪和发红而就诊。1个月前,患者在农场游泳池游泳后开始出现眼部问题。根据我诊所眼科检查诊断为角膜炎。取左角膜刮拭培养进行病原菌鉴定。处方莫西沙星滴眼液和更昔洛韦凝胶10天。治疗后角膜雾霭消失。本病例对延误诊断和治疗的原因进行了评估。我们还比较了成人和婴儿的角膜炎。在鉴别诊断中应考虑铜绿假单胞菌性角膜炎,同时考虑到是否存在治疗抵抗、视力障碍、使用晶状体、鼻泪管阻塞、外伤和不良卫生习惯。先天性鼻泪管梗阻是婴儿死亡的重要危险因素。视力丧失可能发生在成人身上,但由于婴儿的沟通能力有限,他们无法清楚地沟通。铜绿假单胞菌应被认为是引起婴儿患者角膜炎的病原体,特别是当诊断的特征与本病例相符时。
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Non Hospital-Acquired Pseudomonas Aeruginosa Keratitis In a Seven Month Old
Pseudomonas aeruginosa is one of the important pathogens causing bacterial keratitis with ulceration. In this study, we evaluated a case of non-hospital-acquired P. aeruginosa keratitis in a 7-month-old infant and its treatment process. The patient who had no known chronic disease was brought in with complaints of watering and redness in the left eye. The complaint of the eye problems started 1 month ago after the patient swam in a farm pool. Keratitis was diagnosed according to an ophthalmologic examination in our clinic. Left corneal scraping cultures were taken for the identification of the pathogen. Moxifloxacin eye drops and ganciclovir gel were prescribed for 10 days. The corneal haze disappeared after the treatment. Reasons for delay in diagnosis and treatment were evaluated in our case. We also compared the keratitis between adults and infants. P. aeruginosa keratitis should be considered in the differential diagnosis, taking into account the presence of resistance to treatment, visual disturbances, lens usage, nasolacrimal duct obstruction, trauma, and bad hygiene. Congenital nasolacrimal duct obstruction is an important risk factor for infants. Vision loss, which may happen in adults, cannot be clearly communicated by infants due to their limited communication abilities. P. aeruginosa should be considered the pathogen causing keratitis in infant patients, particularly when the diagnosed characteristics align with our case.
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