Cases reported "Corneal Ulcer"

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1/5. aspergillus fumigatus keratitis after laser in situ keratomileusis.

    PURPOSE: To report a case of aspergillus fumigatus keratitis after a laser in situ keratomileusis (LASIK) enhancement procedure. METHOD: Case report. RESULTS: A 56-year-old woman developed an ulcer in the flap 13 days after LASIK enhancement. A 4-week course of fortified antibiotics for a presumed bacterial infection followed. The ulcer progressed, causing 60% thinning of the corneal stroma. A biopsy was performed 5 weeks after onset of symptoms, and antifungal agents were initiated. Cultures showed A. fumigatus. Her cornea perforated after the biopsy, requiring cyanoacrylate and lamellar overlay sutures, but the infiltrate resolved on antifungal agents. CONCLUSION: This report is the first description of Aspergillus keratitis after LASIK. We hypothesize that the infection became established on the stromal bed during surgery and led to melting, anteriorly through the flap and posteriorly through the stroma. diagnosis was made by a corneal biopsy and inoculation of a wide array of media. This case demonstrates the need to consider atypical organisms, including fungi, in the differential diagnosis of post-LASIK infections when there is no response to therapy and highlights the role of corneal biopsy and flap lifting in the diagnosis of this condition.
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keywords = bacterial infection
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2/5. Ocular rosacea in childhood.

    PURPOSE: To describe the clinical characteristics and treatment response of ocular rosacea in the pediatric population. DESIGN: Retrospective case series. methods: The clinic charts of consecutive pediatric cases of ocular rosacea were evaluated over a 34-month period. Minimal diagnostic inclusion criteria were the presence of posterior eyelid inflammation including meibomian gland inspissation and lid margin telangiectasis, in conjunction with conjunctival injection or episcleritis. RESULTS: Six patients ranged from 3 to 12 years of age at presentation. All shared a long history of ocular irritation and photophobia. Five patients (83%) were female and had bilateral involvement. Eyelid telangiectases and meibomian gland disease were present in all cases. Three patients (50%) had sterile corneal ulcers. Only two patients (33%) had cutaneous involvement at the time of diagnosis. All patients experienced significant improvement with a combination of oral antibiotics (doxycycline or erythromycin), with or without topical antibiotics (erythromycin or bacitracin) or topical steroids (fluorometholone). CONCLUSION: Ocular rosacea in children may be misdiagnosed as viral or bacterial infections. Unlike in adults, associated cutaneous changes are uncommon. Most disease is bilateral, although involvement may be asymmetric. Response to conventional treatment is excellent, although long-term treatment may be necessary to prevent relapses.
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keywords = bacterial infection
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3/5. Fourth-generation fluoroquinolones in the treatment of mycobacterial infectious keratitis after laser-assisted in situ keratomileusis surgery.

    Case report: Infectious keratitis after laser-assisted in situ keratomileusis (LASIK) is a rare complication that may be challenging to diagnose and treat. We discuss some of the reasons for difficulties diagnosing postoperative atypical or nontuberculous mycobacterial infection and establishing an effective treatment, with reference to reports of comparative antibacterial activity of the most commonly used antibiotics.Comments: To the best of our knowledge, we are the first to report the use of the fourth-generation fluoroquinolone moxifloxacin in combination therapy for the successful treatment of this condition.
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keywords = bacterial infection
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4/5. Ascorbate therapy in impaired neutrophil and monocyte chemotaxis. With atopy, hyperimmunoglobulinemia E, and recurrent infection.

    A candida albicans corneal ulcer developed in a 24-year-old man with a history of eczema, asthma, and multiple bacterial infections since childhood. The infection responded well to oral flucytosine (12 g/day for 15 days) and topical amphotericin b. Positive laboratory findings included eosinophilla, hyperimmunoglobulinemia E, and impaired neutrophil and monocyte spontaneous migration and chemotactic responses. ascorbic acid corrected the monocyte defect in vitro and in vivo, but had no effect on neutrophil function.
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ranking = 1
keywords = bacterial infection
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5/5. Traditional eye medicines and corneal ulceration in tanzania.

    A one-year prospective study into the aetiology of corneal ulceration in 103 patients attending Mvumi hospital, tanzania, showed 25% (95% CL 16.5-33.5%) of ulcers to be associated with the use of traditional eye medicines (TEM) within the previous 7 days. There was no statistically significant difference between TEM users and non-users in terms of sex of the patients, season of presentation or age at presentation. Of 26 corneal ulcers in TEM users, 58% (n = 15) had no other identified cause of ulceration apart from TEM use. Of the remaining 11, eight showed the appearances of HSV keratitis, and three others had bacterial infection, two with neisseria gonococcus. TEM use was associated with hypopyon at presentation (19.3 vs 2.6% in non-TEM users (P = 0.004)), and there was a trend to more central and dense corneal scarring in the TEM users group (42 vs 23%, P = 0.06). Secondary infection is an important cause of corneal scarring following TEM use, and all patients who have a TEM-associated corneal ulcer should have intensive antimicrobial treatment. TEM use will continue so long as primary eye care continues to be unavailable to the majority of the population of africa.
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ranking = 1
keywords = bacterial infection
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