2只犬伴医源性肾上腺皮质亢进的全眼念珠菌炎

Shu-Fang Yang, Heng-Leng Yang, Peng-Chen Wang, S. Liang
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摘要

两只成年贵宾犬因双眼严重角膜溃疡(oculi uterque [OU])持续1.5个月,眼睑肿胀约1周而被转诊。眼科检查发现弥漫性角膜水肿伴灰色沉积物及溃疡,葡萄膜炎,青光眼,第三眼睑及结膜呈灰色沉积物及坏死,眼睑坏死,眼睑-眼球粘连,失明。结膜和角膜的细胞学检查显示中性粒细胞炎症,细菌培养显示金黄色葡萄球菌。进行促肾上腺皮质激素刺激试验,强烈提示医源性肾上腺皮质亢进。抗生素治疗2周后未见改善。特异性抗真菌治疗包括5%纳他霉素滴眼液(每日6次)和口服伊曲康唑(5[配方:见文]mg/kg q12)。结膜和角膜的灰色沉积物脱落,从而促进角膜和眼睑溃疡在接下来的3-4周内愈合。在6个月的随访后,两只狗都出现了球炎和眼睑-眼球粘连。根据真菌培养分离、临床体征及抗真菌治疗反应,诊断为全眼念珠菌炎。真菌应被认为是全眼炎的潜在微生物,特别是有类固醇和抗生素使用史的人。本病例报告显示,狗的角膜、结膜和第三眼睑的灰色沉积物可能是念珠菌感染的特征。据我们所知,这是第一次报道假丝酵母全眼炎与医源性肾上腺皮质亢进的狗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
CANDIDA PANOPHTHALMITIS WITH IATROGENIC HYPERADRENOCORTICISM IN TWO DOGS
Two adult poodles were referred for severe corneal ulcers in both eyes (oculi uterque [OU]) for 1.5 months, and swollen eyelids for approximately 1 week. Ophthalmic examination revealed diffuse corneal edema with grayish deposit and ulcer, uveitis, glaucoma, grayish deposit and necrosis on the third eyelid and conjunctiva, eyelids necrosis, eyelid-eyeball adhesions, and blindness. Cytological examination of the conjunctiva and cornea revealed neutrophilic inflammation, and a bacterial culture revealed Staphylococcus aureus. An adrenocorticotropic hormone stimulation test was performed, strongly indicating iatrogenic hyperadrenocorticism. No improvement was observed after 2 weeks of antibiotic treatment. Fungal cultures from the cornea and conjunctiva were positive for Candida spp. Specific antifungal treatment included topical 5% natamycin eye drops (OU six times daily) and oral itraconazole (5[Formula: see text]mg/kg q12[Formula: see text]h). The grayish deposits of the conjunctiva and cornea were sloughed off, thus facilitating the healing of corneal and eyelids ulcers, over the next 3–4 weeks. Phthisis bulbi and eyelid-eyeball adhesions developed in both dogs after 6 months of follow-up. Based on the fungal isolation by culture, clinical signs, and response to antifungal treatment, Candida spp. panophthalmitis was diagnosed. Fungi should be considered a potential organism in panophthalmitis, especially with a medical history of steroids and antibiotic use. This case report demonstrates the grayish deposits of the cornea, conjunctiva, and third eyelid as possible characteristics of Candida infection in the dogs. To our knowledge, this is the first report of Candida panophthalmitis with iatrogenic hyperadrenocorticism in dogs.
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