アミロイド沈着を認めた角膜真菌症の1例

A case of keratomycosis associated with localized amyloid deposition

　症例は66歳の女性で，左眼に角膜潰瘍を認めた。角膜擦過物の培養でカンジダが検出され，フルコナゾールの全身・局所投与による治療を試みたが改善が見られないため，治療的全層角膜移植および水晶体嚢外摘出術を行った。摘出角膜の病理組織学的検査で，グロコット染色によりカンジダが同定された。また，実質浅層にコンゴレッド染色陽性，偏光顕微鏡により緑色複屈折性を示すアミロイドの沈着が認められ，ヘルペス性角膜炎あるいは真菌性角膜炎に続発した角膜アミロイドーシスと考えられた。

We report a case of keratomycosis associated with localized amyloid deposition in the cornea. The patient was a 66-year-old female who had suffered from corneal ulcer in the left eye. By culturing the scrapings from the ulcer, Candida albicans was isolated. Since the corneal ulcer deteriorated despite intensive treatment with topical and systemic fluconazole, therapeutic keratoplasty was performed and was successful. Under light microscopic examination of the excised cornea, candida was observed. Amyloid deposits were found in the superficial stroma by Congo-red staining and by electron microscopic examina-tion. The amyloid deposition was considered to be caused by a long-standing inflammatory condition such as herpetic keratitis or keratomycosis.