1/7. Pneumococcal keratitis after laser in situ keratomileusis.A 20-year-old man developed keratitis in his right eye 2 days after laser in situ keratomileusis (LASIK). The patient had rubbed the eye with unclean fingers the night before the onset of symptoms. Examination showed an inferior corneal ulcer with dense infiltration at the junction of the lamellar flap and the surrounding cornea associated with a hypopyon. streptococcus pneumoniae was isolated on culture. The ulcer resolved with combination therapy of cephazolin 5% and tobramycin 1.3% eyedrops. patients having LASIK should be instructed that inadequate patient hygiene may predispose to bacterial keratitis.- - - - - - - - - - ranking = 1keywords = corneal ulcer, keratitis (Clic here for more details about this article) |
2/7. Pneumococcal keratitis at the flap interface after laser in situ keratomileusis.A 28-year-old woman had uneventful laser in situ keratomileusis in the right eye. Six days postoperatively, she reported ocular pain and a large corneal stromal infiltrate was observed at the flap interface. A second surgery including lifting and excising the flap and scraping the stromal bed was performed. Topical antibiotics were prescribed. A bacterial culture revealed streptococcus pneumoniae. The keratitis responded well to topical vancomycin. Twelve days after the second surgery, the stromal infiltrate had regressed, the hypopyon had resolved, and visual acuity was hand movements at 0.5 m.- - - - - - - - - - ranking = 0.57635341765195keywords = keratitis (Clic here for more details about this article) |
3/7. Penetrating keratoplasty following scleral patch graft procedure.PURPOSE: To present the benefit of preserved sclera for immediately repairing perforated corneal ulcer and report the clinical outcome of patients undergoing penetrating keratoplasty after scleral patch graft. patients AND METHOD: The results of perforated corneal ulcer patients, who underwent penetrating keratoplasty after scleral patch graft between January 1996 and December 2002, were reviewed retrospectively. The causes of the corneal ulcer were also included. RESULTS: Penetrating keratoplasty was performed after scleral patch graft for perforated corneal ulcer on four patients, three males and one female. The culture results from corneal scraping showed fusarium spp in two cases and Streptococus pneumoniae in one. One patient had a presumed bacterial corneal ulcer. The post-penetrating keratoplasty visual acuity ranged from hand motions to 20/40. CONCLUSION: The scleral patch graft procedure for perforated corneal ulcer may benefit in circumstances of unavailable corneal donors. The results of penetrating keratoplasty after scleral patch graft were favorable.- - - - - - - - - - ranking = 1.850255392906keywords = corneal ulcer (Clic here for more details about this article) |
4/7. Two cases of pneumococcal keratitis following myopic LASIK.PURPOSE: To report two cases of pneumococcal keratitis after LASIK. methods: Retrospective interventional small case series of two patients who underwent bilateral LASIK for myopia and developed pneumococcal keratitis after surgery. This complication was encountered 2 days after surgery in one eye in both cases. The corneal flap was lifted, and irrigation and cultures from the stromal bed performed. Topical and subconjunctival antibiotics were started. RESULTS: culture revealed streptococcus pneumoniae in both cases. The infiltrates responded well to treatment. One year after the procedure, uncorrected visual acuity is > 20/40 in both cases. CONCLUSIONS: Pneumococcal keratitis can complicate LASIK. patients should be informed of this potential complication, as prompt treatment is crucial.- - - - - - - - - - ranking = 0.80689478471273keywords = keratitis (Clic here for more details about this article) |
5/7. Infectious crystalline keratopathy due to streptococcus pneumoniae. Possible association with serotype.BACKGROUND: Infectious crystalline keratopathy is a distinctive clinical entity characterized by bacterial replication within the corena without inflammation. The authors report on a patient with infectious crystalline keratopathy due to streptococcus pneumoniae serotype 11F. They used this isolate to study the contribution of the pneumococcal polysaccharide capsule to the pathogenesis of the infectious crystalline keratopathy. methods: Aliquots containing 10(6) colony-forming units of pneumococci serotype 11F, serogroup 9 or 15, were inoculated into new zealand white rabbit corneas. The corneas were examined at 24, 48, and 72 hours. Representative corneas were excised at 24 hours and processed for histopathologic analysis. RESULTS: Pauci-inflammatory crystalline lesions developed in all corneas inoculated with the serotype 11F ocular isolate by 24 hours. Suppurative keratitis developed in control corneas inoculated with serogroup 9 or 15 pneumococci. The nonocular 11F isolates produced lesions with some features compatible with infectious crystalline keratopathy. CONCLUSION: Different pneumococcal serotypes vary in their ability to produce infectious crystalline keratopathy. Because serotype differences reflect differences in the antigenic polysaccharides of the bacterial capsule, this study suggests that properties of the pneumococcal capsule may influence the initial development of infectious crystalline keratopathy.- - - - - - - - - - ranking = 0.11527068353039keywords = keratitis (Clic here for more details about this article) |
6/7. Pneumococcal keratitis, bacteremia, and septic arthritis in an asplenic patient.We report the case of a 66-year-old black woman who presented with concomitant acute infectious keratitis, bacteremia, and septic arthritis caused by Streptococcus pneumonia. The septic arthritis resolved rapidly with surgical drainage and intravenous antibiotics, but despite aggressive topical and intravenous antibiotic therapy for the infectious keratitis, the cornea perforated, the patient developed endophthalmitis, and the eye eventually was eviscerated. To the best of our knowledge this is the first reported case of this nature. This patient had undergone splenectomy > 50 years prior to developing these infections. Although the risk of serious infection in clinically significant bacteremia is greatest in the perioperative period after splenectomy, these patients are at increased risk of such events for a lifetime. Because encapsulated bacteria, especially Pneumococcus, pose the greatest risk of sepsis and infection in asplenic patients, pneumococcal vaccination of penicillin prophylaxis must always be considered in these patients. A careful and complete medical history and systemic evaluation remain a crucial element of the evaluation and management of serious infectious keratitis.- - - - - - - - - - ranking = 0.80689478471273keywords = keratitis (Clic here for more details about this article) |
7/7. Nonulcerating bacterial keratitis associated with soft and rigid contact lens wear.OBJECTIVE: An unusual presentation of contact lens-related bacterial keratitis is that of epithelial nodular infiltrates and stromal inflammation without epithelial ulceration. The authors study the initial diagnosis, clinical features, causative organisms, and outcomes of corneal infections presenting in this manner. DESIGN: The study design was a 20-month retrospective chart review. PARTICIPANTS: Five patients with culture-proven bacterial keratitis who had predominantly nodular epithelial lesions were studied. RESULTS: Four infections were associated with soft contact lens wear and one with rigid lens wear. All patients had largely intact epithelium; typical gray-colored epithelial nodules, some with underlying anterior stromal haze; and diffuse, fine, cellular stromal inflammation. Two patients were referred with the tentative diagnosis of acanthamoeba infection and two as contact lens-related sterile keratitis. Epithelial cultures from three cases yielded serratia sp., one yielded corynebacterium, and one streptococcus pneumoniae. All responded to antibacterial medication; final corrected visual acuity in all cases was 20/30 or better. CONCLUSIONS: Bacterial infection associated with contact lens wear can be established within the corneal epithelium without initially producing an ulcer. A wide range of both gram-positive and gram-negative organisms can be involved. Early recognition and treatment appear to result in a favorable outcome.- - - - - - - - - - ranking = 0.80689478471273keywords = keratitis (Clic here for more details about this article) |