Corneal ulcer caused by Lasiodiplodia theobromae: a case report
WANG Chongzhen1, WEI Haodong2, ZHU Xiong1, WANG Licheng1, LI Huan1, FU Xiaoying1, LI Yuanli1, CHEN Dongke1
1. Department of Clinical Laboratory, Central Laboratory, Sanya People’s Hospital, Sanya 572000, Hainan Province, China; 2. Department of Ophthalmology, Sanya People’s Hospital, Sanya 572000, Hainan Province, China
摘要: 本文报告1例可可毛色二孢致角膜溃疡。患者男，54岁，右眼发红，疼痛加重3天。眼科检查见右眼球结膜混合充血，角膜全层灰白色浑浊，呈地图状，面不平，前房下方可见淡白色沉积，余眼内情况窥不清。取角膜刮取物标本进行真菌荧光染色镜检和培养，对培养的菌株进行形态学和分子生物学鉴定，用E-test法进行丝状真菌药敏试验。真菌荧光染色后，镜下可见有隔菌丝。培养14 d有分生孢子座产生，分生孢子位于分生孢子座里。对培养出的丝状真菌进行基因测序，测序后确定病原菌为可可毛色二孢(Lasiodiplodia theobromae, L. theobromae)，临床诊断为可可毛色二孢引起的角膜溃疡。药敏试验结果显示，L. theobromae对两性霉素B和伏立康唑相对敏感。给予局部药物治疗，氟康唑滴眼液q2h滴右眼，同时使用氟康唑氯化钠注射液0.4 g qd静脉滴注。患者治疗5 d未见好转，要求出院。
Abstract：The present paper reported a case of corneal ulcer caused by Lasiodiplodia theobromae. The male patient was 54 years old. His right eye became red and the pain increased for 3 days. Ophthalmic examination showed mixed hyperemia in the bulbar conjunctiva of the right eye. The whole cornea was gray and cloudy, representing an uneven surface like a map. Light white deposition could be seen below the anterior chamber, and the remaining conditions in the eye were not clear. Corneal curettage specimens were taken for fungal fluorescence staining and culture. The cultured strains were identified by morphology and molecular biology. The drug sensitivity of filamentous fungi was tested by E-test. Septahypha can be seen under fluorescent staining of fungi. After incubation for 14 days, conidia could be seen in the conidiophores. The pathogen was identified as Lasiodiplodia theobromae by sequencing. Drug susceptibility result showed that amphotericin B and voriconazole were relatively sensitive.The corneal ulcer was confirmed to be caused by Lasiodiplodia theobromae. The right eye was treated with fluconazole eye drops q2h, and the fluconazole sodium chloride injection was used with 0.4 g qd via intervenous drop infusion. The patient did not get better after 5 days of treatment and asked to be discharged.
王崇圳1，魏昊东2，朱雄1，王立程1，李欢1，符晓莹1，黎元莉1，陈东科1. 可可毛色二孢致角膜溃疡病例分析[J]. 微生物与感染, 2022, 17(6): 380-385.
WANG Chongzhen1, WEI Haodong2, ZHU Xiong1, WANG Licheng1, LI Huan1, FU Xiaoying1, LI Yuanli1, CHEN Dongke1. Corneal ulcer caused by Lasiodiplodia theobromae: a case report. JOURNAL OF MICROBES AND INFECTIONS, 2022, 17(6): 380-385.
2022, Vol. 17 
