1/14. comamonas acidovorans keratitis in a hydrogel contact lens wearer.PURPOSE: To present an unusual case of keratitis in a patient who wears hydrogel contact lenses that are replaced on a monthly basis. The agent isolated was comamonas acidovorans, a species of Pseudomonas. methods AND RESULTS: A 40-year-old patient who wears hydrogel contact lenses that are replaced on a monthly basis presented with a red eye. The patient reported that the eye had been red for 2 days. A peripheral corneal stromal infiltrate was found and comamonas acidovorans was isolated in culture. The patient was initially treated with high-dose gentamicin. After the results of cultures and sensitivity studies were obtained, she was given ciprofloxacin, leading to the remission of the case. CONCLUSIONS: comamonas acidovorans should be considered as a possible agent of keratitis in hydrogel contact lens wearers-a culture and sensitivity studies may be indicated.- - - - - - - - - - ranking = 1keywords = keratitis (Clic here for more details about this article) |
2/14. 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 = 1keywords = keratitis (Clic here for more details about this article) |
3/14. Co-infection of the human cornea with stenotrophomonas maltophilia and aspergillus fumigatus.PURPOSE: To report a case of corneal co-infection of stenotrophomonas maltophilia and aspergillus fumigatus. methods: We describe a culture and biopsy proven infectious keratitis with a large, brown, round anterior chamber mass attached to the endothelium. RESULTS: stenotrophomonas maltophilia was cultured from external scrapings of a corneal ulcer and septate hyphae were stained with Gomori's methenamine silver(GMS) stain along the wall of the excised intracameral mass. aspergillus fumigatus was cultured from the mass and pus pockets developed along the corneoscleral incision for removal of the mass. CONCLUSION: Co-infection of cornea with stenotrophomonas maltophilia and aspergillus fumigatus with existence of a large, brown, smooth-surfaced mass in the anterior chamber makes this case unique and interesting.- - - - - - - - - - ranking = 0.16666666666667keywords = keratitis (Clic here for more details about this article) |
4/14. Clinical presentation of microbial keratitis with daily wear frequent-replacement hydrogel lenses: a case series.Microbial keratitis (MK) is a serious complication associated with contact lens wear. In this case series we report three clinical presentations of MK associated with daily-wear monthly-replacement soft contact lenses. All of these patients were using vifilcon A (55% water content, ionic, U.S. food and Drug Administration [FDA] group IV) monthly-replacement soft contact lenses. A gram-stained smear of the corneal scrapings of two patients showed numerous gram-negative cocci bacilli, and tissue cultures showed significant growth of pseudomonas aeruginosa. In the third patient, the corneal scrapings showed numerous gram-negative bacilli, along with gram-positive cocci, and tissue culture showed significant growth of Aeromonas species and alpha-hemolytic streptococci. All these cases were resolved by medical therapy. This case series highlights the importance of patient symptoms, clinical features, and microbiologic work-up in making a differentiation between MK and sterile contact lens-induced peripheral ulcer (CLPU). A high index of suspicion and close follow-up care will avoid misdiagnosis and reduce complications.- - - - - - - - - - ranking = 0.83333333333333keywords = keratitis (Clic here for more details about this article) |
5/14. Microbial keratitis and vision loss with contact lenses.PURPOSE: Microbial keratitis is the only sight-threatening adverse event that occurs with contact lens wear. This article gives a preliminary estimation of the incidence of microbial keratitis and vision loss with continuous-wear contact lenses made from highly oxygen permeable (Dk) materials. methods: The most up-to-date data available on microbial keratitis and vision loss are collected from a range of sources including industry, private practice, and publications and is reviewed. RESULTS: There have been 16 cases of microbial keratitis with high-Dk silicone hydrogel lenses. Of the 13 where data are available, none have lost two or more lines of best-corrected visual acuity (BCVA). CONCLUSION: First approximation indicates that the incidence of microbial keratitis with high-Dk silicone hydrogel lenses may be lower than the incidence with low-Dk soft lenses during extended wear. The rate of loss of more than two lines of BCVA is low in patients that develop microbial keratitis with low- and high-Dk soft lenses.- - - - - - - - - - ranking = 1.6666666666667keywords = keratitis (Clic here for more details about this article) |
6/14. chryseobacterium meningosepticum keratitis.PURPOSE: To describe a case of a corneal ulcer caused by chryseobacterium meningosepticum in an eye without significant comorbidities. DESIGN: Interventional case report. methods: Retrospective case review. RESULTS: A 48-year-old man presented with a corneal ulcer in his right eye and was treated with ofloxacin and fortified bacitracin ophthalmic solution. Cultures grew C. meningosepticum, and the infection resolved. Two previous case reports in the literature have described ocular infections with this bacterium, both in postoperative patients with significant ocular comorbidities. CONCLUSIONS: This is the first report of ocular infection with C. meningosepticum in an eye with no significant comorbidities.- - - - - - - - - - ranking = 0.66666666666667keywords = keratitis (Clic here for more details about this article) |
7/14. aeromonas caviae keratitis associated with contact lens wear.OBJECTIVE: We report the first case of bilateral contact lens-related aeromonas caviae keratitis associated with A. caviae contamination of the contact lens case. The presence of virulence factors produced by Aeromonas species was also investigated. DESIGN: Case report. INTERVENTION AND TESTING: Conjunctival swabs and corneal scrapings from both eyes were inoculated for culture. The contact lens case was also cultured. The isolate was analyzed for the presence of virulence properties, such as gelatinase and protease production. The presence of virulence genes, such as the cytolytic enterotoxin (AHCYTOEN) and type IV Aeromonas pilus (tap) genes, was investigated using polymerase chain reaction. The susceptibility of A. caviae to 6 commercial contact lens disinfecting solutions was tested. MAIN OUTCOME MEASURES: culture results, protease activity, and gelatinase production were analyzed. polymerase chain reaction amplification products were visualized in ethidium bromide-stained agarose gel. Bacterial growth after exposure to contact lens disinfecting solutions was assessed. RESULTS: aeromonas caviae was grown bilaterally from the conjunctiva, cornea, and contact lens case. The organism showed protease and gelatinase production. polymerase chain reaction amplification revealed that the A. caviae strain contained the AHCYTOEN and tap virulence genes. Incubation for the minimum recommended time with all tested disinfecting solutions was effective in killing A. caviae. CONCLUSIONS: aeromonas caviae should be considered a possible etiologic agent of contact lens-associated keratitis. The presence of virulence factors may be important in determining corneal infection. Commercial contact lens disinfecting solutions, along with proper lens case hygiene, may be effective in preventing A. caviae keratitis in soft contact lens wearers.- - - - - - - - - - ranking = 1.1666666666667keywords = keratitis (Clic here for more details about this article) |
8/14. Recurrent alcaligenes xylosoxidans keratitis.PURPOSE: To describe a case of postkeratoplasty recurrent alcaligenes xylosoxidans keratitis. methods: A 33-year-old man with a history of penetrating keratoplasty developed corneal infiltrate with intact epithelium and then was treated with broad-spectrum antibiotics. Corneal scraping was taken for microbiologic study. RESULTS: The culture result identified A. xylosoxidans, sensitive to piperacillin and ceftazidime. There were 3 recurrent episodes within 2 months after each apparent resolution achieved after the instillation of topical piperacillin (10 mg/mL). During the fourth attack, the lesion responded poorly to piperacillin and ceftazidime (25 mg/mL), so therapeutic penetrating keratoplasty was performed to eradicate the recalcitrant infection. CONCLUSIONS: A. xylosoxidans has probably been underreported as a cause of ocular infection. It does not respond to conventional antibiotic therapy and may be difficult to eradicate. Therapeutic penetrating keratoplasty might be necessary if medical treatment fails.- - - - - - - - - - ranking = 0.83333333333333keywords = keratitis (Clic here for more details about this article) |
9/14. Six cases of scleritis associated with systemic infection.Isolated scleritis (without keratitis) associated with infections is uncommon, and correct diagnosis and appropriate therapy for it are often delayed. Six patients with infection-associated scleritis were seen at our institution between May 1983 and May 1990 (these patients represented 4.6% of all patients with scleritis [six of 130 patients] in that period). Three of these cases were associated with systemic infections. One was associated with syphilis, one was associated with tuberculosis, and one was associated with toxocariasis. Three cases resulted from local infections. One was associated with infection with proteus mirabilis, one was associated with infection with herpes zoster virus, and one was associated with infection with Aspergillus. The Aspergillus infection developed after trauma and the P. mirabilis-induced infection developed after strabismus surgical procedures. Four of the six cases were initially misdiagnosed and inappropriately managed. Correct diagnosis was made seven days to four years after onset of symptoms. review of systems, scleral biopsy, culture, and laboratory investigation were used to make the diagnosis. Differential diagnosis of scleritis must include infective agents.- - - - - - - - - - ranking = 0.16666666666667keywords = keratitis (Clic here for more details about this article) |
10/14. Combined acanthamoeba and stenotrophomonas maltophilia keratitis treated with a conjunctival flap followed by penetrating keratoplasty.PURPOSE: To describe whether a technique of treatment of a combined acanthamoeba-stenotrophomonas keratitis with a conjunctival flap followed by a penetrating keratoplasty is successful. methods: A case of chronic ring-shaped keratitis in which stenotrophomonas maltophilia was isolated with corneal scrapings, and acanthamoeba cysts were found with a corneal biopsy. The infection was resistant to conventional medical treatment. It was treated with a conjunctival flap combined with corneal cryo treatment, followed by a penetrating keratoplasty 6 months later. RESULTS: The patient achieved immediate pain relief after the conjunctival flap. All medications were tapered off over 3 months. A penetrating keratoplasty was performed after 6 months. The cornea remained clear and the best-corrected visual acuity is 20/25 2 years after surgery. CONCLUSIONS: A combined acanthamoeba-stenotrophomonas keratitis, which is resistant to medical therapy, can be treated successfully with a conjunctival flap followed by a penetrating keratoplasty.- - - - - - - - - - ranking = 1.1666666666667keywords = keratitis (Clic here for more details about this article) |
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