Colletotrichum gloeosporioidesによる角膜真菌症

Keratomycosis caused by Colletotrichum gloeosporioides

　82歳男子が6か月前に右眼に白内障手術を受け，以後ステロイド剤を点眼していた。また，2年前から骨髄異形成症候群による汎血球減少症に対して薬物投与を受けていた。右眼に充血と眼痛が生じて当科を受診した。初診時の視力は0.6で，角膜に楕円形で白色の病巣があり，周囲の上皮は欠損していた。角膜擦過物に有隔壁性の菌糸が証明され，Colletotrichum gloeosporioidesと同定された。ピマシリンの点眼とフルコナゾールの点眼と全身投与で角膜病変は治癒した。知る限りでは，本菌種によるヒト感染症は世界で3例目である。

A 81-year-old male had undergone cataract surgery in his right eye and had been treated by topical corticosteroid. He had been treated for pancytopenia secondary to myelodysplasic syndrome since two years before. He sought medical advice for hyperemia and ocular pain in the right eye. When first seen by us, the right visual acuity was 0.6. The right cornea showed white oval lesion surrounded by erosion.Corneal scrapings showed abundant mycelial elements which was later identified as Colletotrichum gloeosporioides. Treatment with topical pimaricin and topical and systemic fluconazole induced cure of the corneal lesion. To our best knowledge, this is the third reported case of corneal infection by this fungus strain.