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Talaromyces allahabadensis¿¡ ÀÇÇÑ Áø±Õ°¢¸·±Ë¾ç

A Fungal Corneal Ulcer Caused by Talaromyces allahabadensis

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Á¶¿ë¿î ( Cho Yong-Wun ) - Gyeongsang National University College of Medicine Department of Ophthalmology
º¯Á¤Çö ( Byun Jung-Hyun ) - Gyeongsang National University College of Medicine Department of Laboratory Medicine
°­ÇöÁö ( Kang Hyun-Ji ) - Gyeongsang National University College of Medicine Department of Ophthalmology
À¯¿õ¼± ( Yoo Woong-Sun ) - Gyeongsang National University College of Medicine Department of Ophthalmology
¼­¼º¿í ( Seo Seong-Wook ) - Gyeongsang National University College of Medicine Department of Ophthalmology
±è¼ºÀç ( Kim Seong-Jae ) - Gyeongsang National University College of Medicine Department of Ophthalmology

Abstract

¸ñÀû: Talaromyces allahabadensis¿¡ ÀÇÇÑ °¢¸·±Ë¾çȯÀÚ¸¦ üÇèÇÏ¿´±â¿¡ º¸°íÇϰíÀÚ ÇÑ´Ù.

Áõ·Ê¿ä¾à: 69¼¼ ³²ÀÚ È¯ÀÚ°¡ Á¾ÈÀÇ ÃæÇ÷ ¹× ÅëÁõÀ¸·Î ¾à 2´Þ ÀüºÎÅÍ °³Àκ´¿ø ¾È°ú¿¡¼­ °á¸·¿° ¹× ÁÖº¯ºÎ Ç츣Æä½º°¢¸·¿°À¸·Î Ä¡·á¸¦ ¹Þ¾ÒÀ¸³ª È£ÀüÀÌ ¾ø¾î º»¿øÀ¸·Î Àü¿øµÇ¾ú´Ù. ȯÀÚ´Â ¾à 2´Þ Àü¿¡ °¨³ª¹«¿¡ Á¾ÈÀ» ¼ö»óÇÑ ÀûÀÌ ÀÖÀ¸¸ç, ³»¿ø ´ç½Ã Àü¾ÈºÎ°Ë»ç»ó ÁÖº¯ºÎ °¢¸·»óÇǰá¼Õ ¹× ±âÁúħÀ±°ú º´º¯ ÁÖÀ§¿¡ ½ÉÇÑ °¢¸·ºÎÁ¾ÀÌ °üÂûµÇ¾ú´Ù. °¢¸·Âû°úÇ¥º»À¸·Î ±×¶÷¿°»ö, KOH µµ¸» ¹× ¹è¾ç°Ë»ç¿¡¼­´Â À½¼ºÀ̾úÀ¸¸ç, ÀÓ»óÀûÀ¸·Î Ç츣Æä½º°¢¸·¿°À¸·Î Áø´ÜÇϰí Ç×¹ÙÀÌ·¯½ºÁ¦¿Í °æÇèÀû Ç×»ýÁ¦¸¦ »ç¿ëÇÏ¿´´Ù. È£Àü°ú ¾ÇÈ­¸¦ ¹Ýº¹ÇÏ¿´À¸³ª, 2ÁÖ°ºÎÅÍ´Â ±âÁúħÀ±ÀÌ Áõ°¡ÇÏ¿© ±×¶÷¿°»ö, KOH µµ¸» ¹× ¹è¾ç°Ë»ç¸¦ ´Ù½Ã ½ÃÇàÇÏ¿´À¸¸ç, ¹è¾ç°Ë»ç¿¡¼­ Talaromyces allahabadensis°¡ °ËÃâµÇ¾ú´Ù. Ç×Áø±ÕÁ¦¸¦ Ãß°¡Çϰí, °¢¸· õ°øÀ§ÇèÀÌ ÀÖ¾î °á¸·ÆÇÀ̽ļúÀ» ½ÃÇàÇÏ¿´À¸¸ç, ÀÌÈÄ °¢¸·¿°Àº È£Àü ¼Ò°ßÀ» º¸¿´´Ù.

°á·Ð: ¿Ü»ó ÀÌÈÄ Ç츣Æä½º°¢¸·¿°À¸·Î Ä¡·á¸¦ ¹Þ´ø ȯÀÚ¿¡¼­ Talaromyces allahabadensis¿¡ ÀÇÇÑ °¢¸·±Ë¾çÀ» Áø´ÜÇϰí Ç×Áø±ÕÁ¦¿Í °á¸·ÆÇÀ̽ļú·Î ¼º°øÀûÀÎ Ä¡·á¸¦ ÇÏ¿´´Ù.

Purpose: Here, we report a case of a fungal corneal ulcer caused by Talaromyces allahabadensis (T. allahabadensis).

Case summary: A 69-year-old male was admitted to our hospital with pain and hyperemia in his left eye after 2 months of treatment at a local clinic for herpetic keratitis. The patient had a previous history of trauma to his left eye caused by a persimmon tree branch. He had a peripheral epithelial defect, stromal infiltration, and severe corneal edema in his left eye. Gram staining, a KOH smear, and a culture were performed using corneal specimens; the results were all negative. With the assumption of herpetic keratitis, antiviral and empirical antibiotic treatments were started. After 2 weeks, the stromal infiltrations on his left eye increased, so we again conducted staining and culture studies. T. allahabadensis was isolated from a specimen, so treatment was started using antifungal agents, and a conjunctival flap graft was performed due to the risk of a corneal perforation.

Conclusions: A case of corneal ulcer caused by T. allahabadensis in a patient with posttraumatic herpetic keratitis was successfully treated with antifungal agents and conjunctival flap surgery.

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Corneal ulcer; Fungal keratitis; Talaromyces allahabadensis; Trauma

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