Microsporidia and Acanthamoeba: the role of emerging corneal pathogens.
Microsporidia and Acanthamoeba: the role of emerging corneal pathogens.
复制标题
微孢子虫和棘阿米巴：新兴角膜病原体的作用。
DOI：
10.1038/eye.2011.315
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发表时间：
2012
期刊：
影响因子：
--
通讯作者：
Joslin,CE
中科院分区：
文献类型：
--
作者：
Tu,EY;Joslin,CE
越来越多的人认识到寄生生物是人类角膜病原体。明确定义的阿米巴角膜炎的显著增加和微孢子虫角膜炎报告病例的更显著增加表明世界各地寄生虫角膜炎的重大爆发。历史和当代基线以及熟悉的相关临床表现加强了美国阿米巴角膜炎的重大爆发。然而，微孢子虫角膜炎病例的显著增加缺乏这些既定的基线，并且进一步描述了一种与以前的疾病定义不一致的疾病。虽然明确定义的突然增加强烈表明与阿米巴爆发有关的时间相关的风险因素，最有可能是环境因素，但微孢子虫角膜炎的增加表明，提高认识和改善诊断敏锐性是病例确定的重要因素。无论如何，最近的证据表明，这两种寄生虫病可能在各种形式的感染性角膜炎中报告不足，这可能在原发性原生动物和多微生物角膜炎的发病机制中具有未被认识但重要的意义。进一步了解这些微生物与当前治疗方案和更常见病原体的发病率和相互作用，应能显著改善诊断并改变临床结局。
Parasitic organisms are increasingly recognized as human corneal pathogens. A notable increase in both well-defined Acanthamoeba keratitis and a more dramatic increase in reported cases of Microsporidia keratitis have suggested significant outbreaks of parasitic keratitis around the world. Historical and contemporary baselines as well as a familiar associated clinical presentation reinforce the significant outbreak of Acanthamoeba keratitis in the United States. The remarkable rise in cases of Microsporidia keratitis, however, lacks these established baselines and, further, describes a disease that is inconsistent with previous definitions of disease. While a well-defined, abrupt increase strongly suggests temporally related risk factors, most likely environmental, involved in the Acanthamoeba outbreak, the rise in Microsporidia keratitis suggests that increased awareness and improved diagnostic acumen are a significant factor in case ascertainment. Regardless, recent evidence indicates that both parasitic diseases are likely underreported in various forms of infectious keratitis, which may have unrecognized but significant implications in the pathogenesis of both primary protozoal and polymicrobial keratitis. Further understanding of the incidence and interaction of these organisms with current therapeutic regimens and more commonly recognized pathogens should significantly improve diagnosis and alter clinical outcomes.