아크로모박테르 자일로속시단스에 의한 각막궤양 1예
A Case of Achromobacter Xylosoxidans Keratitis
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목적: 농부에서 발생한 아크로모박테르 자일로속시단스(Achromobacter xylosoxidans)에 의한 각막염 1예를 경험하여 이를 보고하고자 한다. 증례요약: 농사일을 하던 중 소꼬리에 눈을 스친 이후 발생한 이물감 및 충혈로 4일간의 개인의원 치료에도 호전이 없어 내원한 68세의건강한 남자 환자에서 각막찰과표본을 얻어 그람염색 및 세균배양검사, 항생제감수성검사 등을 시행하였다. 세균배양검사상 아크로모박테르 자일로속시단스가 검출되었고, 목시플록사신과 세프타지딤 점안 항생제 치료 후 치료 3개월째 각막에 경미한 혼탁만을 남기고완전히 치료되었다. 결론: 동물의 분변이나, 토양에 오염된 물질에 외상 후 발생한 각막궤양으로 내원한 환자에서 흔하지는 않지만 원인균으로 아크로모박테르 자일로속시단스를 고려해야 하고, 도말검사상 그람 음성 간균이 검출되었으나 국소적인 침윤을 보이면서 서서히 진행하는 경우에도 의심되어야 한다.
Abstract
Purpose: To report a case of corneal ulcer caused by Achromobacter xylosoxidans in a farmer. Case summary: A previously healthy 68-year-old man presented with unilateral redness and irritation after his eye was grazed by a cow’s tail. The patient had previously been treated in a local clinic for four days without improvement. Bacterial staining, culture, and an antibiotic sensitivity test were performed from a corneal scrape. The cultures revealed growth of A. xylosoxidans. The patient was treated with moxifloxacin and ceftazidime eyedrops. After three months of treatment, the infection was resolved with mild scarring. Conclusions: Although it is a rare pathogen, A. xylosoxidans should be considered as a potential pathogen in patients presenting with corneal ulceration due to trauma from an object contaminated by soil or animal feces and having a slowly progressive disease and localized infiltrate but showing Gram-negative bacilli on smear examination.
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