백내장수술 후 발생한 라울텔라 플란티콜라 안내염 1예 = A Case of Raoultella planticola Endophthalmitis after Cataract Surgery

국문 초록 (Abstract)

목적: 백내장수술 후 Raoultella planticola에 의해 발생한 안내염을 처음으로 경험하였기에 이를 보고하고자 한다.
증례요약: 49세 남자 환자가 초음파 수정체 유화술 및 회절성 다초점 비구면 인공수정체 삽입술 시행 2일 뒤부터 발생한 우안 시력저하와 안구 통증을 주소로 내원하였다. 전안부 검사상 각막부종 및 전방축농 소견이 관찰되었으며 유리체 혼탁과 전방 염증으로 인해 안저는 관찰되지 않았다. 안내염 의심하 유리체 절제술과 전방 내 vancomycin HCl 0.3 mg/0.1 mL 그리고 유리체강 내 vancomycin HCl 1.0 mg/0.1 mL와 ceftazidime 2.0 mg/0.1 mL 주입술을 시행하였고, 전방수 및 유리체액 세균배양 검사에서 Raoultella planticola 가 검출되었다. 항생제 감수성 결과에 따라 ceftazidime을 정맥주사하였고 vancomycin과 ceftazidime 조제 점안약을 사용하였다. 치료 4개월 후 최대 교정시력은 20/20이었으며 재발의 소견은 관찰되지 않았다.
결론: 본 증례를 통해 Raoultella planticola에 의한 안내염은 적절한 치료로 비교적 좋은 예후를 보일 수 있음을 알 수 있었다. 백내장 수술 후 발생한 안내염의 경우 안내염의 흔한 세균들뿐만 아니라 Raoultella planticola 같은 드문 균에 의한 감염 가능성도 고려해야 할 것이다.
<대한안과학회지 2016;57(10):1651-1655>

다국어 초록 (Multilingual Abstract)

Purpose: To report the first case of the Raoultella planticola endophthalmitis after the phacoemulsification and posterior chamber multi-focused intraocular lens (IOL) implantation.
Case summary: A healthy 49-year-old male visited our clinic with a sudden visual disturbance and ocular pain 2 days after phacoemulsification and multi-focused IOL implantation in his right eye. On initial ophthalmic examination, severe corneal edema and hypopyon were observed. The retina could not be visualized due to vitreous opacity and anterior chamber inflammation. Therefore, the patient immediately underwent pars plana vitrectomy. Vancomycin hydrogen chloride (HCl) 0.3 mg/0.1 mL was injected into the anterior part and vancomycin HCl 1.0 mg/0.1 mL and ceftazidime 2.0 mg/0.1 mL were injected into the intravitreal part. The culture test of aqueous humor and vitreous body fluid revealed Raoultella planticola, thus, systemic antibiotic (ceftazidime) and antibiotic eye drops (vancomycin and ceftazidime) were administered. After 4 months of follow-up, best-corrected visual acuity improved to 20/20 in the affected eye after surgery.
Conclusions: In the present case, we found that endophthalmitis due to Raoultella planticola can be successfully treated. We suggest that atypical bacteria should be considered in the differential diagnosis of endophthalmitis after cataract surgery.
J Korean Ophthalmol Soc 2016;57(10):1651-1655

목차 (Table of Contents)

• 증례보고
• 고 찰
• REFERENCES

참고문헌 (Reference)

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