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Candida albicansによる真菌性眼内炎3症例を経験し,各々に異なる治療法を行い比較検討した。症例1は49歳男性で,交通外傷後全身感染症をおこし,抗生剤の長期大量投与をうけていた。経過中カンジダ血症がみられ,Amphoter-icin B (以下AMT-Bと略す)の点滴静注を行ったが受傷2ヵ月後両眼の視力低下をきたし,眼内炎を起こしていた。その後視力の改善なく,両眼とも瘢痕化した。症例2は53歳男性で,敗血症を起こし抗生剤の大量投与が行われていた。約1ヵ月後両眼の視力低下を来し,眼内炎を起こしており5-fluorocytosineの経口投与と,vitrectomy後にAMT-Bの硝子体注入を行い軽度の視力改善をみ,瘢痕治癒した。症例3は47歳女性で胞状奇胎術後,またネフローゼ症候群のためステロイド剤の長期大量投与が行われていた。約1ヵ月後に両眼視力低下をきたし,虹彩炎と網膜の滲出性病変を認めた。治療はAMT-Bの全身投与は続行できず,0.05mg/ml AMT-Bの結膜下注射を隔日投与し,著名な視力の改善を認めた。我々は症例3がAMT-Bの結膜下注射にて明らかな視力の改善を認めたことから,今後Candida性眼内炎の積極的治療のひとつとして試みるべきであると考えた。
We treated 3 cases of endophthalmitis due to candida albicans with different therapeutic modalities. A 49-year-old male developed systemic candidiasis with bilateral ocular involvement 2 months after multiple injury due to traffic accident. Treatment with intravenous infusion of amphoter-icin B resulted in macular and vitreous scarring. A 53-year-old male developed systemic candidiasis during treatment for septicemia. Both eyes manifested vitreous abscess. After peroral 5-fluor-ocytosine and vitrectomy with intravitreal am-photericin B injection in the right eye, both eyesresulted in macular scarring. A 47-year-old female developed bilateral endophthalmitis during intra-venous prednisolone therapy for nephrosis which developed after hysterectomy. She was treated with subconjunctival injection of amphotericin B because of allergic reaction to the drug when ad-ministered intravenously. Final visual acuity of 0.5 was attained in the treated eye. Administration of amphotericin B through subconjunctival route seemed to be of value either as adjuncto or as alternative to systemic one.
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