Cases reported "Eye Infections, Bacterial"

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1/200. Late infection of hydroxyapatite orbital implants.

    BACKGROUND: Exposure and minor complications of hydroxyapatite orbital implants are common. infection appears to be rare and fibrovascular ingrowth into hydroxyapatite implants may make infection and extrusion less likely than with other types of orbital implant. methods: We describe three cases of chronic low-grade infection of hydroxyapatite implants, occurring late after apparently uncomplicated surgery, with tiny or inapparent areas of conjunctival loss or exposure. RESULTS: Two of the three cases grew Staphylococcus oureus on culture. All three implants ultimately needed to be removed. A characteristic histological pattern was seen, with abrupt transition between vascularized and abscessed implant. CONCLUSIONS: Chronic infection of hydroxyapatite implants can occur late, in the absence of large conjunctival defects, or other obvious risk factors.While exposure of the implant to pathogens through a breach in the conjunctiva may have been a factor, it appeared that the infection may have arisen in an avascular portion of the implant prior to the conjunctival breakdown in one or more of these cases.
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ranking = 1
keywords = culture
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2/200. Streptococcal keratitis after myopic laser in situ keratomileusis.

    A 24-year-old healthy male underwent uncomplicated laser in situ keratomileusis (LASIK) in left eye. One day after the surgery, he complained of ocular pain and multiple corneal stromal infiltrates had developed in left eye. Immediately, the corneal interface and stromal bed were cleared, and maximal antibiotic treatments with fortified tobramycin (1.2%) and cefazolin (5%) were given topically. The causative organism was identified as 'streptococcus viridans' both on smear and culture. Two days after antibiotic therapy was initiated, the ocular inflammation and corneal infiltrates had regressed and ocular pain was relieved. One month later, the patient's best corrected visual acuity had returned to 20/20 with -0.75 -1.00 x 10 degrees, however minimal stromal scarring still remained. This case demonstrates that microbial keratitis after LASIK, if treated promptly, does not lead to a permanent reduction in visual acuity.
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keywords = culture
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3/200. Bacterial keratitis following laser in situ keratomileusis for hyperopia.

    A 42-year-old Bahraini man had uneventful laser in situ keratomileusis for hyperopia (OD: 3.00 0.75 x 155 degrees; OS: 2.00 0.50 x 155 degrees). Three weeks later, he presented with localized keratitis in his right eye, with localized keratitis at the flap margin with stromal edema. Uncorrected visual acuity was 20/80 OD with no improvement with pinhole, and was 20/20 OS. Corneal smear culture showed a positive growth of staphylococcus aureus. The patient was immediately treated with subconjunctival gentamicin and intensive topical ofloxacin 0.3% with systemic cephalosporin. The patient recovered from keratitis within 2 weeks and his uncorrected visual acuity OD improved to 20/20. keratitis following LASIK should be treated promptly so that it does not lead to permanent reduction in visual acuity.
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keywords = culture
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4/200. A case of bacterial endophthalmitis following perforating injury caused by a cat claw.

    A case of bacterial endophthalmitis following a perforating ocular injury caused by a cat claw is reported. The scleral wound was sutured immediately following the injury and systemic antibiotics were administered. Despite this treatment, endophthalmitis occurred 3 days after the injury. The endophthalmitis was resolved by pars plana vitrectomy, however preretinal reproliferation and retinal detachment subsequently occurred. After reoperation the retina was reattached and the corrected visual acuity improved from 10 cm/HM to 20/200. pseudomonas aeruginosa was detected in cultured vitreous humor that was collected during surgery. This case illustrates the possibility of endophthalmitis being caused by gram negative bacillus in cases of perforating injuries caused by animal claws. Perforating ocular injuries caused by animal claws are relatively rare. Here we report a case of endophthalmitis due to pseudomonas aeruginosa that occurred after a perforating injury caused by a cat claw. The eye was treated by pars plana vitrectomy.
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ranking = 1
keywords = culture
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5/200. Bilateral Pseudomonas corneal ulcer in a disposable contact lens wearer.

    PURPOSE: To describe a case of bilateral corneal ulcers caused by Pseudomonas in a disposable soft contact lens wearer. This case study discusses the role of patient examination, contact lens care instruction, and adequate patient supervision in reducing the risk of serious potential complications. methods AND RESULTS: A 17 year old student who had been using disposable soft contact lenses on an extended wear basis for 6 months presented complaining of pain in the left eye. When he was examined, a corneal ulcer with surrounding infiltrate was observed in the superior middle periphery of the left eye. Samples were collected for culture, and treatment with fortified cefalotin and gentamicin was started. After 8 hours the patient returned, now complaining of pain in the right eye. Examination of the right eye revealed a diffused keratitis with a mucopurulent discharge. A culture was taken, and the same treatment was instituted. The laboratory tests revealed Pseudomonas in both eyes. The bilateral corneal ulcers responded to therapy after 1 week of treatment. CONCLUSIONS: We discuss the factors involved in the occurrence of infectious keratitis in contact lens wearers, and stress that even disposable contact lens wear can be associated with serious complications. This case also highlights extended wear as one of the main risk factors for complications in disposable soft contact lens wear.
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ranking = 2
keywords = culture
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6/200. Use of a low nutrient culture medium for the identification of bacteria causing severe ocular infection.

    A low nutrient culture medium was used to identify the pathogens in four cases of persisting ocular infection. Bacto R2A agar was used in addition to conventional liquid- and solid-phase media to culture pathogenic bacteria from one case of recurrent keratitis, one case of suture-related keratitis with endophthalmitis and two eyes (two patients) with post-operative endophthalmitis. In each case, a pathogen was identified solely with R2A agar after culture for 6 days. Species isolated were pseudomonas aeruginosa (one), propionibacterium acnes (two) and staphylococcus aureus (one). Antibiotic therapy was tailored to conform to the sensitivity of the cultured organism in each case. The use of Bacto R2A low nutrient agar should be considered in culture negative eyes not showing clinical improvement, or for chronic cases where bacteria may have become adapted to more stringent ocular environments.
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ranking = 9
keywords = culture
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7/200. Extensive destruction of the eyeball by invasion of basal cell carcinoma of the eyelid.

    BACKGROUND: Eyeball destruction caused by invasion of basal cell carcinoma of the eyelid. CASE: A 100-year-old woman showed extensive eyeball destruction caused by the invasion of basal cell carcinoma of the eyelid. Complete ophthalmologic examinations, including computed tomographic (CT) scans of the orbit, were performed. The patient underwent incisional biopsy and bacteriological examination of the exudate from the lesion. OBSERVATIONS: Orbital CT scan showed a mass in the extraconal space of the right orbit, with extension to the adjacent sinus cavity without brain involvement. The remnant of the eyeball was posteriorly displaced. pseudomonas aeruginosa was identified by culture examination of the exudate. Histological study of the biopsy specimen showed basal cell carcinoma of the noduloulcerative type. CONCLUSIONS: Basal cell carcinoma of the eyelid had caused severe periorbital and eyeball destruction.
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ranking = 1
keywords = culture
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8/200. Preseptal cellulitis secondary to proteus species: a case report and review.

    BACKGROUND: Preseptal cellulitis is a serious ocular condition that--if left untreated--has the potential to cross the septal barrier, spread to the posterior orbit, and may result in fatal complications. Because it is difficult to determine the pathogen responsible for any cellulitis without aspirating a culture sample, treatment is usually instituted by an assumption of the most common causative organisms, Staphylococcus or streptococcus. CASE REPORT: A 42-year-old black woman manifested signs and symptoms consistent with right preseptal cellulitis. Throughout treatment, visual acuity remained 20/20 for both eyes, extraocular muscles were unrestricted without pain, and anterior globe structures were clear. The patient was started on a regimen of 250-mg oral dicloxacillin four times a day. When no response was seen at 36 hours, the patient was changed to 500-mg oral ciprofloxacin every 12 hours. She responded to the 500-mg ciprofloxacin and recovered with no sequelae. An abscess, which had formed during the cellulitis, self expressed and this material was cultured. The cultures identified the responsible organism as proteus species, an unexpected pathogen in a well-groomed patient. CONCLUSION: This case demonstrates the need to consider alternate pathogens when treating preseptal cellulitis, change medications accordingly, and consider alternate treatments as needed.
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ranking = 3
keywords = culture
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9/200. Infectious keratitis after photorefractive keratectomy in a comanaged setting.

    A 48-year-old man had simultaneous bilateral photorefractive keratectomy (PRK). The surgeon who performed the PRK did not see the patient in follow-up, and there was confusion regarding the comanaging doctor. Therefore, the patient was not examined immediately postoperatively. Several days later, he was hospitalized for an unrelated, painful orthopedic problem and heavily sedated. Seven days after the PRK, an ophthalmologist was consulted for ocular irritation and discharge. Examination showed bilateral, purulent conjunctivitis and severe infectious keratitis in the left eye. The patient was treated with periocular and topical antibiotics. Corneal cultures yielded staphylococcus aureus. The keratitis resolved slowly, leaving the patient with hand motion visual acuity. A corneal transplant and cataract extraction was performed 15 months later, resulting in a best corrected visual acuity of 20/400 because of glaucomatous optic nerve damage. Severe infectious keratitis may occur after PRK. Poor communication between the surgeon, comanaging doctor, and patient may result in treatment delay.
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ranking = 1
keywords = culture
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10/200. Bilateral consecutive central corneal perforations associated with hypogammaglobulinemia.

    OBJECTIVE: To describe the presentation and the clinical course of a patient with consecutive central sterile corneal perforations associated with common variable immunodeficiency. DESIGN: Case report. methods: Multiple corneal cultures and scrapings were performed in an effort to identify an infectious cause and all were negative. Corneal biopsy did not demonstrate any evidence of micro-organisms. An extended investigation failed to uncover a collagen vascular cause or atopy. RESULTS: Progressive sterile stromal thinning with intact epithelium in the left eye proceeded to perforation despite topical treatment, and cyanoacrylate gluing was performed. However, a secondary haemophilus influenza endophthalmitis developed, and the eye was eventually lost. The fellow eye proceeded along the same clinical course with sterile stromal thinning. A lamellar patch graft was performed when the central ulceration progressed to a descemetocele. The eye remained quiet with 20/25 vision for 2 years, until the patient died from complications of a liver transplant. CONCLUSIONS: Devastating central sterile corneal thinning leading to perforation may occur in patients with hypogammaglobulinemia.
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ranking = 1
keywords = culture
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