Amphotericin Bの結膜下注射が奏効したScopulariopsis brevicaulisによる角膜真菌症

Successful treatment of keratomycosis due to Scopulariopsis brevicaulis by topical Amphotericin B. Report of a case

　前房内吸引物の検索により早期に診断できたScoputariepsis brevicaulisによる稀な角膜真菌症の1例を報告する．初診時には右眼角膜中央部の全層混濁，角膜中央から下方にいたる灰白色後面沈着物および眼圧上昇を認め，後にデスメ膜の皺や典型的な角膜潰瘍を呈した．PimaricinとAmphotericin Bの点眼，5-fluorocytosine （5-FC）の内服を施行したが効果が不十分であり，Amphotericin Bの点滴静注は副作用が強いために使用に耐えず，Amphotericin Bの結膜下注射が著効を呈した．

A 40-year-old female, a user of hard contact lens for the past 20 years, developed painful blurring in her right eye. Instillation of sulbenicillin eye-drops was effective till the symptoms recurred in more aggravated form 3 weeks later. The patient was referred to us 6 weeks after the initial occur-rence of symptoms.

The right eye presented with stromal opacity of the central cornea, dense grayish plaque in the endothelium of the lower cornea and elevated intraocular pressure. The lesion developed into typi-cal corneal abscess one week later in spite of intensive treatment with antibiotics. A fungus strain, Scopulariopsis brevicaulis, was isolated from aspi-rated endothelial plaque material. Subconjunctival injection of Amphotericin B was effective in curing the lesion and in bringing the final visual acuity to 0. 7 .