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NEJM：棘阿米巴角膜炎-病例报道

2019-07-18 xing.T MedSci原创

棘阿米巴角膜炎视力模糊
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她接受了棘阿米巴角膜炎的诊断，这是一种威胁视力的感染，最常见于佩戴隐形眼镜的人群。患者用局部聚己酰胺和丙胺脒羟乙基磺酸盐治疗。虽然感染得到了解决，但由于中央角膜瘢痕和白内障密集，左眼视力无法恢复。

患者为一名41岁的女性，因间歇性疼痛、视力模糊和左眼光敏感2个月而到眼科就诊。她每月戴一次性软性隐形眼镜，在游泳和淋浴时也一直戴在眼睛上。

体格检查，患者难以保持左眼张开，结果发现结膜发红。右眼视力为20/20，左眼视力为20/200。左眼中存在较大的环状浸润物，伴随着角膜混浊和覆盖的上皮缺陷，其存在荧光素染料摄取。来自角膜刮屑的培养物得到了棘阿米巴（Acanthamoeba polyphaga）。



她接受了棘阿米巴角膜炎的诊断，这是一种威胁视力的感染，最常见于佩戴隐形眼镜的人群。患者用局部聚己酰胺和丙胺脒羟乙基磺酸盐治疗。虽然感染得到了解决，但由于中央角膜瘢痕和白内障密集，左眼视力无法恢复。

在最初的就诊后12个月，患者接受了深层前板层角膜移植术，术后视力为20/80，左眼无不适。
 
原始出处：

Lanxing Fu,et al.Acanthamoeba Keratitis.N Engl J Med 2019;https://www.nejm.org/doi/full/10.1056/NEJMicm1817678

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1976068, encodeId=c35219e6068e8, content=<a href='/topic/show?id=2300626294a' target=_blank style='color:#2F92EE;'>#棘阿米巴#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62629, encryptionId=2300626294a, topicName=棘阿米巴)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f00658, createdName=yyanpro@21cn.c, createdTime=Sun Aug 18 22:32:00 CST 2019, time=2019-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1349177, encodeId=2c1d13491e7e4, content=<a href='/topic/show?id=4337909284a' target=_blank style='color:#2F92EE;'>#角膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=90928, encryptionId=4337909284a, topicName=角膜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Fri Jul 19 22:32:00 CST 2019, time=2019-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1391805, encodeId=2bc31391805a7, content=<a href='/topic/show?id=0e0590964e3' target=_blank style='color:#2F92EE;'>#角膜炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=90964, encryptionId=0e0590964e3, topicName=角膜炎)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq2AGzrugK9ZUjU3eJxzM901ophWib0xJDrSicy49ibWl3zB5pbDto7eoR6tnzwOiaKdbq1a8PcbYFFrw/132, createdBy=6ff22500098, createdName=ms4964546379600229, createdTime=Fri Jul 19 22:32:00 CST 2019, time=2019-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034888, encodeId=e8be103488866, content=顶刊就是顶刊，谢谢梅斯带来这么高水平的研究报道，我们科里同事经常看梅斯，分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Jul 18 10:32:00 CST 2019, time=2019-07-18, status=1, ipAttribution=)]
    2019-08-18 yyanpro@21cn.c

    #棘阿米巴#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1976068, encodeId=c35219e6068e8, content=<a href='/topic/show?id=2300626294a' target=_blank style='color:#2F92EE;'>#棘阿米巴#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62629, encryptionId=2300626294a, topicName=棘阿米巴)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f00658, createdName=yyanpro@21cn.c, createdTime=Sun Aug 18 22:32:00 CST 2019, time=2019-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1349177, encodeId=2c1d13491e7e4, content=<a href='/topic/show?id=4337909284a' target=_blank style='color:#2F92EE;'>#角膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=90928, encryptionId=4337909284a, topicName=角膜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Fri Jul 19 22:32:00 CST 2019, time=2019-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1391805, encodeId=2bc31391805a7, content=<a href='/topic/show?id=0e0590964e3' target=_blank style='color:#2F92EE;'>#角膜炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=90964, encryptionId=0e0590964e3, topicName=角膜炎)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq2AGzrugK9ZUjU3eJxzM901ophWib0xJDrSicy49ibWl3zB5pbDto7eoR6tnzwOiaKdbq1a8PcbYFFrw/132, createdBy=6ff22500098, createdName=ms4964546379600229, createdTime=Fri Jul 19 22:32:00 CST 2019, time=2019-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034888, encodeId=e8be103488866, content=顶刊就是顶刊，谢谢梅斯带来这么高水平的研究报道，我们科里同事经常看梅斯，分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Jul 18 10:32:00 CST 2019, time=2019-07-18, status=1, ipAttribution=)]
    2019-07-19 snowpeakxu

    #角膜#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1976068, encodeId=c35219e6068e8, content=<a href='/topic/show?id=2300626294a' target=_blank style='color:#2F92EE;'>#棘阿米巴#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62629, encryptionId=2300626294a, topicName=棘阿米巴)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f00658, createdName=yyanpro@21cn.c, createdTime=Sun Aug 18 22:32:00 CST 2019, time=2019-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1349177, encodeId=2c1d13491e7e4, content=<a href='/topic/show?id=4337909284a' target=_blank style='color:#2F92EE;'>#角膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=90928, encryptionId=4337909284a, topicName=角膜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Fri Jul 19 22:32:00 CST 2019, time=2019-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1391805, encodeId=2bc31391805a7, content=<a href='/topic/show?id=0e0590964e3' target=_blank style='color:#2F92EE;'>#角膜炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=90964, encryptionId=0e0590964e3, topicName=角膜炎)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq2AGzrugK9ZUjU3eJxzM901ophWib0xJDrSicy49ibWl3zB5pbDto7eoR6tnzwOiaKdbq1a8PcbYFFrw/132, createdBy=6ff22500098, createdName=ms4964546379600229, createdTime=Fri Jul 19 22:32:00 CST 2019, time=2019-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034888, encodeId=e8be103488866, content=顶刊就是顶刊，谢谢梅斯带来这么高水平的研究报道，我们科里同事经常看梅斯，分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Jul 18 10:32:00 CST 2019, time=2019-07-18, status=1, ipAttribution=)]
    2019-07-19 ms4964546379600229

    #角膜炎#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1976068, encodeId=c35219e6068e8, content=<a href='/topic/show?id=2300626294a' target=_blank style='color:#2F92EE;'>#棘阿米巴#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62629, encryptionId=2300626294a, topicName=棘阿米巴)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f00658, createdName=yyanpro@21cn.c, createdTime=Sun Aug 18 22:32:00 CST 2019, time=2019-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1349177, encodeId=2c1d13491e7e4, content=<a href='/topic/show?id=4337909284a' target=_blank style='color:#2F92EE;'>#角膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=90928, encryptionId=4337909284a, topicName=角膜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Fri Jul 19 22:32:00 CST 2019, time=2019-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1391805, encodeId=2bc31391805a7, content=<a href='/topic/show?id=0e0590964e3' target=_blank style='color:#2F92EE;'>#角膜炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=90964, encryptionId=0e0590964e3, topicName=角膜炎)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq2AGzrugK9ZUjU3eJxzM901ophWib0xJDrSicy49ibWl3zB5pbDto7eoR6tnzwOiaKdbq1a8PcbYFFrw/132, createdBy=6ff22500098, createdName=ms4964546379600229, createdTime=Fri Jul 19 22:32:00 CST 2019, time=2019-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034888, encodeId=e8be103488866, content=顶刊就是顶刊，谢谢梅斯带来这么高水平的研究报道，我们科里同事经常看梅斯，分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Jul 18 10:32:00 CST 2019, time=2019-07-18, status=1, ipAttribution=)]
    2019-07-18 旺医

    顶刊就是顶刊，谢谢梅斯带来这么高水平的研究报道，我们科里同事经常看梅斯，分享梅斯上的信息

    0