ISSN: 1859 - 2872
Báo cáo một trường hợp viêm giác mạc do nocardia sau phẫu thuật smile
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Keywords
Viêm giác mạc do Nocardia, phẫu thuật SMILE
Tóm tắt
Chúng tôi báo cáo trường hợp bệnh nhân nữ, 22 tuổi, đến khám vì mắt trái đau nhức, mờ, chảy nước mắt kéo dài 6 ngày. Bệnh nhân đã được chẩn đoán viêm giác mạc và điều trị bằng thuốc tra mắt Levofloxacin 1,5%, Natamycin 5% nhưng không đỡ. Tiền sử 2 mắt đã phẫu thuật SMILE điều trị cận thị trước khi bị bệnh 8 ngày. Khám sinh hiển vi thấy giác mạc có ổ loét trung tâm kích thước 1,5x1,5mm, thâm nhiễm nhu mô dạng vòng kích thước 4x5mm với bờ dạng lông vũ trong mặt gian cách, kèm ngấn mủ tiền phòng. Kết quả nhuộm soi chất nạo bờ ổ loét thấy Nocardia. Bệnh nhân được điều trị bằng tra mắt Amikacin 5% kèm uống Biseptol và có đáp ứng tốt trong 3 ngày đầu. Tuy nhiên nhiễm trùng có biểu hiện nặng lên sau khi ổ loét biểu mô hoá. Bệnh nhân được chuyển phác đồ điều trị bằng Meropenem tra mắt kèm truyền tĩnh mạch. Ổ viêm giác mạc đã được điều trị khỏi và để lại sẹo kèm tân mạch giác mạc
Article Details
Các tài liệu tham khảo
1. Afsharpaiman S, Zare M, Yasemi M, Jamialahmadi T, Sahebkar A (2020) The Prevalence of Infectious Keratitis after Keratorefractive Surgery: A Systematic Review and Meta-Analysis Study. Journal of Ophthalmology 2020(1):6329321.
2. Das S, Garg P, Mullick R, Annavajjhala S (2020) Keratitis following laser refractive surgery: Clinical spectrum, prevention and management. Indian J Ophthalmol 68(12): 2813-2818.
3. Liu J, Guo X, Wei Z et al (2023) Infectious Keratitis After Keratorefractive Surgery: Update and Review of the Literature. Eye & contact lens. Publish Ahead of Print.
4. Sridhar U, Tripathy K (2020) Commentary: Infectious keratitis after small incision lenticule extraction. Indian J Ophthalmol 68(12): 3066-3070.
5. Chehaibou I, Sandali O, Ameline B, Bouheraoua N, Borderie V, Laroche L (2016) Bilateral infectious keratitis after small-incision lenticule extraction. Journal of Cataract & Refractive Surgery 42: 626-630.
6. Li J, Ren SW, Dai LJ et al (2022) Bacterial Keratitis Following Small Incision Lenticule Extraction. Infect Drug Resist 15: 4585-4593.
7. Soleimani M, Haydar AA (2021) Fungal keratitis after small incision lenticule extraction (SMILE): a case report and review of the literature. Journal of Ophthalmic Inflammation and Infection 11(1):25.
8. Wan K, Lam J, Lam N, Chow V (2021) Late-Onset Nontuberculous Mycobacterial Keratitis After Small Incision Lenticule Extraction. Cornea. Publish Ahead of Print.
9. Soltani Shahgoli S, Cheraqpour K, Soleimani M et al (2023) Post-laser refractive surgery keratitis: A concise narrative review. J Int Med Res 51(10):3000605231206054.
10. Soleimani M, Masoumi A, Khodavaisy S, Heidari M, Haydar AA, Izadi A (2020) Current diagnostic tools and management modalities of Nocardia keratitis. J Ophthalmic Inflamm Infect 10(1): 36.
11. Javadi MA, Kanavi MR, Zarei-Ghanavati S et al (2009) Outbreak of Nocardia keratitis after photorefractive keratectomy: clinical, microbiological, histopathological, and confocal scan study. J Cataract Refract Surg 35(2): 393-398.
12. Garg P, Sharma S, Vemuganti GK, Ramamurthy (2007) A cluster of Nocardia keratitis after LASIK. J Refract Surg 23(3): 309-312.
13. Johansson B, Fagerholm P, Petranyi G, Claesson Armitage M, Lagali N (2017) Diagnostic and therapeutic challenges in a case of amikacin-resistant Nocardia keratitis. Acta Ophthalmologica 95(1): 103-105.
14. Wroblewski KJ, Pasternak JF, Bower KS et al (2006) Infectious keratitis after photorefractive keratectomy in the United States army and navy. Ophthalmology 113(4): 520-525.
15. Alhemyari MH, Satarasi P, Joseph J, Bagga B (2024) Nocardia keratitis after small incision lenticule extraction (SMILE). BMJ Case Rep 17(5).
16. Malik M, Akhtar F, Khaliq Bhinder K et al (2022) Diagnostics and Clinical Care of Nocardia Keratitis. Journal of Microbiology and Infectious Diseases: 31-34.
17. Sueke H, Kaye S, Wilkinson MC et al (2015) Pharmacokinetics of Meropenem for Use in Bacterial Keratitis. Investigative Ophthalmology & Visual Science 56(10): 5731-5738.
18. Elhardt C, Wolf A, Wertheimer CM (2023) Successful treatment of multidrug-resistant Pseudomonas aeruginosa keratitis with meropenem eye drops - a case report. J Ophthalmic Inflamm Infect 13(1): 40.
2. Das S, Garg P, Mullick R, Annavajjhala S (2020) Keratitis following laser refractive surgery: Clinical spectrum, prevention and management. Indian J Ophthalmol 68(12): 2813-2818.
3. Liu J, Guo X, Wei Z et al (2023) Infectious Keratitis After Keratorefractive Surgery: Update and Review of the Literature. Eye & contact lens. Publish Ahead of Print.
4. Sridhar U, Tripathy K (2020) Commentary: Infectious keratitis after small incision lenticule extraction. Indian J Ophthalmol 68(12): 3066-3070.
5. Chehaibou I, Sandali O, Ameline B, Bouheraoua N, Borderie V, Laroche L (2016) Bilateral infectious keratitis after small-incision lenticule extraction. Journal of Cataract & Refractive Surgery 42: 626-630.
6. Li J, Ren SW, Dai LJ et al (2022) Bacterial Keratitis Following Small Incision Lenticule Extraction. Infect Drug Resist 15: 4585-4593.
7. Soleimani M, Haydar AA (2021) Fungal keratitis after small incision lenticule extraction (SMILE): a case report and review of the literature. Journal of Ophthalmic Inflammation and Infection 11(1):25.
8. Wan K, Lam J, Lam N, Chow V (2021) Late-Onset Nontuberculous Mycobacterial Keratitis After Small Incision Lenticule Extraction. Cornea. Publish Ahead of Print.
9. Soltani Shahgoli S, Cheraqpour K, Soleimani M et al (2023) Post-laser refractive surgery keratitis: A concise narrative review. J Int Med Res 51(10):3000605231206054.
10. Soleimani M, Masoumi A, Khodavaisy S, Heidari M, Haydar AA, Izadi A (2020) Current diagnostic tools and management modalities of Nocardia keratitis. J Ophthalmic Inflamm Infect 10(1): 36.
11. Javadi MA, Kanavi MR, Zarei-Ghanavati S et al (2009) Outbreak of Nocardia keratitis after photorefractive keratectomy: clinical, microbiological, histopathological, and confocal scan study. J Cataract Refract Surg 35(2): 393-398.
12. Garg P, Sharma S, Vemuganti GK, Ramamurthy (2007) A cluster of Nocardia keratitis after LASIK. J Refract Surg 23(3): 309-312.
13. Johansson B, Fagerholm P, Petranyi G, Claesson Armitage M, Lagali N (2017) Diagnostic and therapeutic challenges in a case of amikacin-resistant Nocardia keratitis. Acta Ophthalmologica 95(1): 103-105.
14. Wroblewski KJ, Pasternak JF, Bower KS et al (2006) Infectious keratitis after photorefractive keratectomy in the United States army and navy. Ophthalmology 113(4): 520-525.
15. Alhemyari MH, Satarasi P, Joseph J, Bagga B (2024) Nocardia keratitis after small incision lenticule extraction (SMILE). BMJ Case Rep 17(5).
16. Malik M, Akhtar F, Khaliq Bhinder K et al (2022) Diagnostics and Clinical Care of Nocardia Keratitis. Journal of Microbiology and Infectious Diseases: 31-34.
17. Sueke H, Kaye S, Wilkinson MC et al (2015) Pharmacokinetics of Meropenem for Use in Bacterial Keratitis. Investigative Ophthalmology & Visual Science 56(10): 5731-5738.
18. Elhardt C, Wolf A, Wertheimer CM (2023) Successful treatment of multidrug-resistant Pseudomonas aeruginosa keratitis with meropenem eye drops - a case report. J Ophthalmic Inflamm Infect 13(1): 40.
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Jun 22, 2026
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NgaD. M., CungL. X., & HồngN. T. (2026). Báo cáo một trường hợp viêm giác mạc do nocardia sau phẫu thuật smile. Journal of 108 - Clinical Medicine and Phamarcy, 21(5). https://doi.org/10.52389/ydls.v21i5.3053