Methenamine-silver-stained corneal scrapings in keratomycosis.
Methenamine-silver-stained corneal scrapings in keratomycosis.
复制标题
角膜真菌病中六胺银染色的角膜刮片。
DOI：
10.1016/0002-9394(76)90431-1
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发表时间：
1976
影响因子：
4.2
通讯作者：
G. Rebell
中科院分区：
文献类型：
--
作者：
R. Forster;M. Wirta;M. Solis;G. Rebell
如果早期开始用那他霉素或其他有效药物进行局部抗真菌治疗，大多数病例的真菌性角膜炎可以成功治疗。1-7通常感染被迅速停止，并且不需要手术干预。最终的视力取决于抗真菌治疗开始时病变的严重程度和部位以及对治疗的反应，因此，角膜真菌病的诊断和治疗必须是立即的。在大多数情况下，通过角膜刮片的显微镜检查可以立即诊断。然而，在一年诊断和治疗大约12个这样的溃疡后，我们对目前用于此目的的革兰氏和吉姆萨染色以及KOH湿封片越来越不满意。8-10在一些情况下，我们观察到这些技术对真菌的染色和定义较差，即使培养物中的刮片生长出多个真菌菌落也是如此（表）。我们还发现，要在许多这些病例中检测真菌或识别导致假阳性诊断的伪影，需要更多的肌性角膜炎经验;这些问题在早期溃疡中尤其重要，因为早期溃疡中可能存在很少的真菌，并且角膜溃疡中可能存在真菌。
Most cases of mycotic keratitis can be treated successfully if topical antimycotic therapy with natamycin or other effective agents is started early. 1-7 Usually the in fection is halted promptly, and surgical intervention is not required. Final visual acuity depends on the severity and loca tion of the lesion existing at the outset of antimycotic treatment, and the response to therapy.Thus, diagnosis and treatment of keratomycosis must be immediate. In most cases an immediate diagnosis is possible by microscopic examination of corneal scrapings. However, after diagnosing and treating approximately 12 of these ulcers a year, we have become increasingly dis satisfied with the Gram and Giemsa stains and the KOH wet mount currently used for this purpose. 8-10 In several cases we observed poor staining and definition of fungi with these techniques, even when multiple colonies of fungi grew from the scrapings in culture (Table). We also found that one needs more than occasion al experience with mycotic keratitis to detect fungi in many of these prepara tions, or to recognize the artifacts that lead to false-positive diagnoses; These problems are especially important in early ulcers where there may be little fungus present, and where the corneal