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A Case of Keratitis Caused by Combined Infection of Multidrug-Resistant Acinetobacter Baumannii and Candida Parapsilosis
ÃÖÀ籤 ( Choi Jae-Kwang ) - »ïÀ°¼¿ïº´¿ø ¾È°ú
±èÀÎÇõ ( Kim In-Hyuk ) - »ïÀ°¼¿ïº´¿ø ¾È°ú
¼Á¤¿ø ( Seo Jung-Won ) - »ïÀ°¼¿ïº´¿ø ¾È°ú
Abstract
¸ñÀû: Àå±â°£ 0.5% Levofloxacin°ú 0.1% FluorometholoneÀ» Á¡¾ÈÇÑ È¯ÀÚ¿¡¼ ´ÙÁ¦³»¼º Acinetobacter baumannii¿Í Candida parapsilosis ¿¡ º¹ÇÕ°¨¿°µÈ °¢¸·¿° 1¿¹¸¦ °æÇèÇÏ¿© À̸¦ º¸°íÇϰíÀÚ ÇÑ´Ù.
Áõ·Ê¿ä¾à: ¹«µ¿¼º ¹«¾îÁõ(akinetic mutism) »óÅ·Πº»¿ø ½Å°æ¿Ü°ú¿¡ ÀÔ¿ø ÁßÀÎ 55¼¼ ³²ÀÚ È¯ÀÚ°¡ ÁÂ¾È °á¸· ÃæÇ÷°ú ´«°öÀ» ÁÖ¼Ò·Î ¾È°ú ·Î ÀǷڵǾú´Ù. ȯÀÚ´Â 2³â ÀüºÎÅÍ 0.5% Levofloxacin°ú 0.1% FluorometholoneÀ» Á¡¾ÈÇϰí ÀÖ¾ú´Ù. Á¾ȿ¡¼ ºÒ±ÔÄ¢ÇÑ ¸ð¾ç(3.5¡¿4.5 mm)ÀÇ °¢¸·±Ë¾çÀÌ °üÂûµÇ¾ú´Ù. °¢¸·¿¡¼ ½ÃÇàÇÑ ¹è¾ç°Ë»ç¿¡¼ ´ÙÁ¦³»¼º A. baumannii¿Í C. parapsilosisÀÌ µ¿Á¤µÇ¾úÀ¸¸ç, Ç×»ýÁ¦ °¨ ¼ö¼º °Ë»ç¸¦ Åä´ë·Î 10% Piperacillin/Tazobactam°ú 0.125% Amphotericin B Á¡¾È¾×À» Ãʱ⿡´Â 1½Ã°£ °£°ÝÀ¸·Î ½ÃÀÛÇÏ¿© °¨·®ÇÏ¿´ ´Ù. Á¡¾È 8ÁÖ° °¢¸·±Ë¾çÀº °¢¸· ȥŹÀ» ³²±ä ÈÄ Ä¡·áµÇ¾ú´Ù.
°á·Ð: ´ÙÁ¦³»¼º A. baumannii¿Í C. parapsilosis¿¡ ÀÇÇÑ °¢¸·¿° 1¿¹¸¦ ±¹³» ÃÖÃÊ·Î °æÇèÇÏ¿© º¸°íÇÏ´Â ¹ÙÀÌ´Ù.
Purpose: To report a case of keratitis caused by Acinetobacter baumannii and Candida parapsilosis in a patient using 0.5% levofloxacin and 0.1% fluorometholone for an extended period of time.
Case summary: A 55-year-old male patient in the neurosurgery department with conjunctival injection and discharge in his left eye was consulted for ophthalmic evaluation and treatment. He was hospitalized in the state of akinetic mutism and given 0.5% levofloxacin and 0.1% fluorometholone for 2 years. On slit-lamp examination, a 3.5 ¡¿ 4.5-mm dense stromal infiltrate with an overlying epithelial defect was observed. Corneal scraping culture revealed multidrug-resistant A. baumannii and C. parapsilosis. According to the susceptibility result, the patient was treated with topical 10% piperacillin/ tazobactam and 0.125% amphotericin B hourly. The corneal ulcer healed gradually with corneal opacity remaining after 8 weeks of treatment.
Conclusions: The authors of the present study report a case of treated multidrug-resistant A. baumannii and C. parapsilosis keratitis in a patient using topical antibiotics and steroid for an extended period of time.
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Acinetobacter baumannii; Candida parapsilosis; Combined infection; Keratitis; Multidrug-resistant
KMID :
0360220120530081167
DOI :
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