1/45. Vibrio ocular infections on the U.S. Gulf Coast.PURPOSE: To describe the epidemiology of Vibrio eye infections. METHOD: We reviewed the records of a patient from our institution with V. vulnificus keratitis and conducted a literature search for other cases of ocular infections with Vibrio species. RESULTS: A 39-year-old fisherman was struck in his left eye with an oyster shell fragment, developed suppurative V. vulnificus keratitis, and was successfully treated with combined cefazolin and gentamicin. Including our patient, 17 cases of eye infections with Vibrio spp. have been reported, and 11 (65%) involved exposure to seawater or shellfish. Of the seven cases due to V. vulnificus (six keratitis and one endophthalmitis), six had known exposure to shellfish or seawater along the U.S. coast of the gulf of mexico. Of five cases of V. alginolyticus conjunctivitis, three had been exposed to fish or shellfish. Three infections with V. parahaemolyticus (one keratitis and two endophthalmitis) were reported; two of these occurred in people exposed to brackish water on or near the Gulf Coast. Two cases of postsurgical endophthalmitis, one with V. albensis and one with V. fluvialis, also were reported. CONCLUSIONS: In addition to septicemia, gastroenteritis, and wound infections, halophilic noncholera Vibrio species can cause sight-threatening ocular infections. Ocular trauma by shellfish from contaminated water is the most common risk factor for Vibrio conjunctivitis and keratitis. Nearly one half of reported vibrio infections of the eye occurred along the U.S. coast of the gulf of mexico.- - - - - - - - - - ranking = 1keywords = keratitis (Clic here for more details about this article) |
2/45. vibrio vulnificus corneal ulcer: rapid resolution of a virulent pathogen.PURPOSE: To describe a corneal ulcer due to vibrio vulnificus that resolved rapidly with antibiotic therapy alone. METHOD: Case report and review of literature. RESULTS: This is the third reported case of corneal ulcer due to V. vulnificus. All followed trauma sustained during oyster shucking. Both prior cases required invasive therapy to achieve a cure. Our case responded rapidly to hourly treatment with ciprofloxacin, Neosporin, and fortified vancomycin. CONCLUSION: V. vulnificus is a virulent pathogen that can infect the cornea after shellfish injury to the eye. Clinical suspicion and early therapy with appropriate antibiotics can lead to an excellent outcome.- - - - - - - - - - ranking = 1.3795841141972keywords = corneal ulcer, ulcer (Clic here for more details about this article) |
3/45. Nocardia keratitis after traumatic detachment of a laser in situ keratomileusis flap.PURPOSE: Nocardia are gram-positive bacteria existing ubiquitously in the environment; they can cause keratitis. nocardia asteroides keratitis occurred in the interface between the stromal bed and flap after traumatic detachment of the flap 4 months after an initially uncomplicated laser in situ keratomileusis (LASIK) procedure. methods: nocardia asteroides keratitis was confirmed by culture. Therapy included topical and oral trimethoprim-sulfamethoxazole. RESULTS: Thirteen months after the trauma, the patient's spectacle-corrected visual acuity was 20/20 with a manifest refraction of -2.25 -1.00 x 30 degrees. CONCLUSIONS: The immediate steps of management consisting of surgically lifting the corneal flap, rapid microbial identification, and proper treatment with specific antibiotics resulted in the successful treatment of nocardia asteroides keratitis in a traumatized eye after LASIK.- - - - - - - - - - ranking = 1.6keywords = keratitis (Clic here for more details about this article) |
4/45. Late traumatic dislocation of laser in situ keratomileusis corneal flaps.PURPOSE: To report the management and outcome of late-onset traumatic dislocation of laser in situ keratomileusis (LASIK) flaps. DESIGN: Retrospective, observational case series. PARTICIPANTS: Four patients with late-onset LASIK flap dislocation occurring after mechanical trauma at various intervals (10 days-2 months) after the procedure. INTERVENTION: In all cases of postoperative traumatic LASIK flap dislocation, the flap was refloated with scraping and irrigation of the underlying stromal bed within 12 hours of the injury. A bandage contact lens was placed, and a regimen including topical antibiotics and corticosteroids was instituted in all cases. MAIN OUTCOME MEASURES: Best spectacle-corrected visual acuity and complications associated with the surgery were monitored. RESULTS: Postoperative follow-up ranged from 4 to 21 months. Nonprogressive epithelial ingrowth was noted in one patient and diffuse lamellar keratitis developed in another patient. All patients recovered pretrauma spectacle-corrected visual acuity. CONCLUSIONS: Corneal LASIK flaps are prone to mechanical dislocation as late as 2 months after the procedure. Appropriate management results in recovery of optimal visual outcomes.- - - - - - - - - - ranking = 0.2keywords = keratitis (Clic here for more details about this article) |
5/45. Fungal keratitis caused by pseudallescheria boydii (scedosporium apiospermum).keratitis is rarely caused by fungi. Filamentous fungal keratitis is often preceded by corneal trauma and occurs mostly in previously healthy individuals. We studied a case of posttraumatic keratitis caused by pseudallescheria Boydii, which belongs to the group of filamentous fungi.- - - - - - - - - - ranking = 1.2keywords = keratitis (Clic here for more details about this article) |
6/45. Corneal co-infection with scedosporium apiospermum and acanthamoeba after sewage-contaminated ocular injury.PURPOSE: To describe a corneal co-infection with the fungus scedosporium apiospermum and acanthamoeba that result in spontaneous corneal perforation. methods: A 27-year-old man presented due to severe ocular pain in his left eye caused by a corneal ulcer. The patient was injured 7 days before presentation by metallic thread contaminated by sewage. Corneal scrapping and deep stromal biopsy were obtained and stained for microscopic evaluation with periodic acid-Schiff, Giemsa, and Gomori's methenamine silver stains. Samples were sent for aerobic and anaerobic bacterial and fungal cultures. RESULTS: Corneal biopsy and corneal scrapping showed viable acanthamoeba cysts in the corneal stroma and S. apiospermum micelle, respectively. The fungal culture was sensitive to ketoconazole, miconazole, econasole, and traconazole. Devastating corneal perforation occurred despite aggressive antifungal and antiamoebic topical and systemic treatment initiated after diagnosis. The corneal button showed a necrotic tissue devoid of inflammatory cells and microorganisms. CONCLUSION: S. apiospermum and acanthamoeba may co-infect immune privilege sites, such as the cornea, in immunocompetent hosts. Compromised corneal surface, e.g., after trauma by sewage-contaminated objects, may increase the susceptibility for such devastating coinfection. Prevention may be possible by use of protective eyewear by high-risk individuals. Treatment should be initiated promptly with broad-spectrum antimicrobial agents after ocular injury by sewage-contaminated objects. Repeated corneal cultures and biopsies, if the cultures are negative, are warranted. Corticosteroids should be withheld until the causative agents are identified and targeted treatment is initiated.- - - - - - - - - - ranking = 0.22993068569953keywords = corneal ulcer, ulcer (Clic here for more details about this article) |
7/45. Traumatic flap displacement and subsequent diffuse lamellar keratitis after laser in situ keratomileusis.A 45-year-old man was struck in the left eye by the edge of a paper shopping bag 3 weeks after having laser in situ keratomileusis (LASIK). The injury resulted in partial displacement of the LASIK flap. The patient developed diffuse lamellar keratitis (DLK) the day after the flap was repositioned. By day 4, visual acuity diminished to 20/60. By day 9, the clinical evidence of the DLK had resolved, and by day 15, uncorrected visual acuity was 20/20. Eye trauma 3 weeks after LASIK can result in displacement of the LASIK flap, and DLK can develop following flap replacement. Long-term anatomic and visual results are usually good.- - - - - - - - - - ranking = 1keywords = keratitis (Clic here for more details about this article) |
8/45. Cat's tooth keratitis: human corneal infection with capnocytophaga canimorsus.PURPOSE: To describe a patient with keratitis caused by capnocytophaga canimorsus after traumatic injury with a cat's tooth. methods: Case report and review of the literature. RESULTS: Sixteen months after onset of infection, the patient regained 20/30 vision in the affected eye. However, he required 7 months of antibiotic therapy to eliminate the infection. CONCLUSION: C. canimorsus keratitis may follow penetrating corneal injury and wound contamination with cat saliva and may be recalcitrant to topical antibiotic therapy.- - - - - - - - - - ranking = 1.2keywords = keratitis (Clic here for more details about this article) |
9/45. Intracameral amphotericin b: initial experience in severe keratomycosis.PURPOSE: Fungal keratitis is a significant cause of ocular morbidity in india. The most commonly implicated fungi are Aspergillus spp. patients often present with hypopyon, which usually contains fungal elements. The treatment is difficult owing to poor intraocular penetration of most available antifungal agents. This study evaluated the results of intracameral injection of amphotericin b in natamycin resistant cases of severe keratomycosis. methods: Three patients of culture proven aspergillus flavus corneal ulcer with hypopyon not responding to topical natamycin 5%, amphotericin b 0.15%, and oral itraconazole were administered intracameral amphotericin b. The first case received 7.5 microg in 0.1 mL followed by two subsequent injections of 10 microg in 0.1 mL each, the second case received two injections of 10 microg in 0.1 mL, and the third patient received a single dose of 10 microg in 0.1 mL. culture of the aqueous sample also grew A. flavus in all three cases. RESULTS: All three cases responded favorably, with the ulcer and hypopyon clearing completely. There was no clinical evidence of corneal or lenticular toxicity in any patient. CONCLUSIONS: Intracameral amphotericin b may be a useful modality in the treatment of severe keratomycosis not responding to topical natamycin. It ensures adequate drug delivery into the anterior chamber and may be especially useful to avoid surgical intervention in the acute stage of the disease.- - - - - - - - - - ranking = 0.43028006024399keywords = corneal ulcer, keratitis, ulcer (Clic here for more details about this article) |
10/45. More than tears in your eyes (exophiala jeanselmei keratitis).PURPOSE: To describe a patient with exophiala jeanselmei keratitis. methods. CASE REPORT: One patient with persistent corneal infiltrate that developed several days after a minor ocular trauma from an onion slice. RESULTS: culture plates from corneal scraping showed a growth of the yeast exophiala jeanselmei, a rare causative agent of ocular infection. CONCLUSIONS: Whenever a corneal abscess does not improve with the usual antibiotic treatment, a thorough ophthalmic history should be taken to determine whether there was a recent ocular trauma. If the trauma was caused by a plant material, the physician should raise the possibility of an unusual fungal infection.- - - - - - - - - - ranking = 1keywords = keratitis (Clic here for more details about this article) |
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