徐一　毛丽萍　顾云峰　王大选　陈鹏飞　郑美琴温州医科大学附属眼视光医院检验科，浙江温州325000

诺卡菌致角膜感染2例及文献复习

徐一毛丽萍顾云峰王大选陈鹏飞郑美琴▲温州医科大学附属眼视光医院检验科，浙江温州325000

目的加深对诺卡菌性角膜炎的认识，提高临床诊疗水平。方法分析2012年1月和2016年1月收治的2例诺卡菌性角膜炎病例的临床表现、实验室检查、诊治过程，并进行文献复习。结果该病临床表现无特异性，患者多伴有免疫功能低下及外伤史，诊断主要依据细菌学检查。结论诺卡菌性角膜炎是罕见的眼部疾病，其发病病程较长，易误诊，细菌培养和鉴定是诊断该病的金标准。早期找到病因及合理的用药是诊治该病的关键。

诺卡菌；感染；角膜炎；细菌培养

[Abstract]Objective To improve the diagnosis and treatment of the nocardia keratitis.Methods Two cases with no鄄cardia keratitis were diagnosed in January 2012 and January 2016 respectively,the clinical features,laboratory mani鄄festation and diagnosis and treatment process of the two cases were analyzed and the related literatures were reviewed. Results The disease was lack of specific clinical feature,also could be with low immune function and trauma history. The most precise diagnosis could be provided by bacteriology examination.Conclusion The nocardia keratitis is a rare eye disease,the disease course is long,easy to misdiagnosis.bacterial culture and identification is the gold standard for diagnosis of this disease.Early to find the cause of the disease and rational drug use is the key to the diagnosis and treatment of the disease.

[Key words]Nocardia;Infection;Keratitis;Bacterial culture

诺卡菌病（灶燥糟葬则凿蚤燥泽蚤泽）是由诺卡菌感染引起的一种罕见病，以肺部感染最多见[1，2]，而其所致的角膜感染国内外少有报道，仅占细菌性角膜炎的0.3%～0.8%[3]。因其病程较长，早期症状轻，临床表现与真菌感染或病毒感染较为相似，临床难以做出及时、正确的诊断，值得临床医师高度警惕。本文报道我院2例诺卡菌所致的角膜炎病例，并结合近年来国内外诺卡菌感染相关的文献进行复习，以提高对诺卡菌病的认识，减少误诊漏诊。

1　临床资料

病例1，患者男，52岁，因野右眼被耶电缆线爷击伤后眼痛20 d，加重3 d冶于2012年1月9日拟野右眼细菌性角膜炎、右眼眼球钝挫伤冶收住入院。入院后眼……