Alternaria에 의한 감염결정각막병증
Infectious Crystalline Keratopathy Caused by Alternaria
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목적: 각막 중심에 발생한 Alternaria에 의한 감염결정각막병증 1예를 경험하였기에 이를 보고하고자 한다. 증례요약: 66세 남자 환자가 1개월 전에 밭일 중 우안에 이물이 튀는 각막외상 후에 지속적인 우안 통증과 시력저하로 내원하였다. 각막수술이나 장기간 스테로이드 점안액 사용의 과거력은 없었다. 각막 중심에 상피결손과 각막기질 주위로 백색의 눈송이 모양의 침윤이 보였으나 심한 기질염증은 없었고, 결막충혈이나 전방염증은 관찰되지 않았다. 도말 배양 및 조직검사상 Alternaria 균종이 검출되었다. 1% voriconazole 점안액, 0.5% moxifloxacin 점안액과 경구 vorizonazole (400 mg/day)을 이용하여 2개월간 치료 후 병변 부위에 미세한 각막혼탁을 남기고 완치되었다. 결론: 저자들은 국내에서 보고된 적 없는 Alternaria에 의한 감염결정각막병증 1예를 성공적으로 치험하였기에 이를 보고하는 바이다.
Abstract
Purpose: To report a case of infectious crystalline keratopathy caused by Alternaria in the corneal center. Case summary: A 66-year-old male visited our clinic with right ocular pain and visual loss after corneal trauma caused by a foreign body hitting his right eye while performing farm work 1 month prior to his visit. The patient had no history of corneal surgery and long-term use of topical corticosteroid. A corneal epithelial defect and whitish snowflake margin infiltration around the corneal stroma were observed in the corneal center, but there was an absence of conjunctival injection and anterior segment inflammation. Cultures and a biopsy of the corneal scrapings revealed Alternaria species fungus. The patient was treated with 1% topical voriconazole and 0.5% moxifloxacin, together with oral voriconazole (400 mg/day). After 2 months of treatment, the disease was completely cured, with a minute corneal opacity. Conclusions: We successfully treated a rare case of infectious crystalline keratopathy caused by Alternaria, which has not been previously reported in the Republic of Korea.
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