Candida albicansによる内因性眼内炎の1例

A Rare Case of Blood-Borne Candida Endophthalmitis

緒言

　抗生剤の普及による菌交代現象ならびに免疫抑制剤の使用による宿主の抵抗力の減弱とが相まつて，非病原菌による感染，すなわちopportuni—stic infectionが注目されている。このなかで，もっとも典型的なものはCandida症であるといわれている^1）。

　眼科における真菌症の一つとして，内因性Can—dida性眼内炎がある。これについて，欧米にはかなりの報告例^{2〜5,8,9,13,14,16）}があるが，本邦には詳細に報告された症例はまだない。

An unusual case of blood-borne Candida en-dophthalmitis in a 34-year-old male is presented. The patient, a 34-year-old factory worker, suffer from traumatic amputation of fingers and was surgically treated immediately. Elev-en days later, while the patient was under treatment with systemic broad-spectrum anti-biotics, lasting high fever had set in. Eight days after, visual disturbance, photophobia and ocular pain had set in. Funduscopy revealed infiltrative chorioretinal lesions with massive vitreous opacity in both eyes. Recurrent vit-reous hemorrhage set in later.

Candida albicans was identified through cult-ure of pus obtained from abscess of his breast which developed following systemic steroid and antituberculotic therapy. The endophthalmitis seems to have been caused by Candida infection during surgery and by prolonged use of anti-biotics. The ocular findings resulted in remark-able im provement through administration of Amphotericin B totalling 434mg.