Polymicrobial Keratitis After a Collagen Cross-Linking Procedure With Postoperative Use of a Contact Lens: A Case Report

被引:100
作者
Zamora, Katherine V. [1 ]
Males, John J. [1 ,2 ]
机构
[1] Sydney Eye Hosp, Corneal Unit, Sydney, NSW 2000, Australia
[2] Save Sight Inst, Sydney, NSW, Australia
关键词
collagen cross-linking; UV-A; keratitis; Streptococcus salivarius; Streptococcus oralis; CORNEAL COLLAGEN; STREPTOCOCCUS-SALIVARIUS; ULTRAVIOLET-A; ANTIBIOTIC SUSCEPTIBILITY; PROGRESSIVE KERATOCONUS; RIBOFLAVIN; ENDOPHTHALMITIS; PERFORATION; MENINGITIS; THERAPY;
D O I
10.1097/ICO.0b013e31818d381a
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
Purpose: To report a case of polymicrobial keratitis caused by Streptococcus salivarius, Streptococcus oralis, and coagulase-negative Staphylococcus sp. in a patient who underwent collagen cross-linking for keratoconus. Method: Case report. Result: A 32-year-old male presented with a 1-day history of a painful red eye, occurring 3 days after he had undergone a collagen cross-linking with riboflavin and UV-A on his left eye for keratoconus. He admitted to removing his bandage contact lens and cleaning it in his mouth before reapplying it in his eye. On presentation, a severe keratitis with an 8-mm epithelial defect and 360-degree ring infiltrate was found. Culture results from his contact lens were positive for S. salivarius and S. oralis, and coagulase-negative Staphylococcus sp. were grown from his corneal scrapings. Conclusions: Collagen cross-linking is a promising procedure for the treatment of progressive keratoconus with minimal reported side effects. However, the possibility of a secondary infection after the procedure exists because the patient is subjected to epithelial debridement and the application of a soft contact lens. The role of the UV light on the immune mechanisms of the cornea and its effect on corneal wound healing warrant further investigation.
引用
收藏
页码:474 / 476
页数:3
相关论文
共 24 条
[1]   Parasurgical therapy for keratoconus by rib oflavin-ultraviolet type A rays induced cross-linking of corneal collagen - Preliminary refractive results in an Italian study [J].
Caporossi, A ;
Baiocchi, S ;
Mazzotta, C ;
Traversi, C ;
Caporossi, T .
JOURNAL OF CATARACT AND REFRACTIVE SURGERY, 2006, 32 (05) :837-845
[2]  
FARLEY MM, 2000, KELLEYS TXB INTERNAL, pCH275
[3]   Effect of complete epithelial debridement before riboflavin-ultraviolet-A corneal collagen crosslinking therapy [J].
Hayes, Sally ;
O'Brart, David P. ;
Lamdin, Letitia S. ;
Doutch, James ;
Samaras, Kostas ;
Marshall, John ;
Meek, Keith M. .
JOURNAL OF CATARACT AND REFRACTIVE SURGERY, 2008, 34 (04) :657-661
[4]   STREPTOCOCCUS-SALIVARIUS ENDOPHTHALMITIS FROM CONTAMINATED DONOR CORNEA AFTER KERATOPLASTY [J].
HEIDEMANN, DG ;
DUNN, SP ;
HAIMANN, M .
AMERICAN JOURNAL OF OPHTHALMOLOGY, 1989, 107 (04) :429-430
[5]   Meningitis due to Streptococcus salivarius [J].
Idigoras, P ;
Valiente, A ;
Iglesias, L ;
Trieu-Cuot, P ;
Poyart, C .
JOURNAL OF CLINICAL MICROBIOLOGY, 2001, 39 (08) :3017-3017
[6]   Origins of Staphylococcus epidermidis and Streptococcus oralis causing bacteraemia in a bone marrow transplant patient [J].
Kennedy, HF ;
Morrison, D ;
Kaufmann, ME ;
Jackson, MS ;
Bagg, J ;
Gibson, BES ;
Gemmell, CG ;
Michie, JR .
JOURNAL OF MEDICAL MICROBIOLOGY, 2000, 49 (04) :367-370
[7]   Herpetic keratitis with iritis after corneal crosslinking with riboflavin and ultraviolet A for keratoconus [J].
Kymionis, George D. ;
Portaliou, Dirnitra M. ;
Bouzoukis, Dirnitrios I. ;
Suh, Leejee H. ;
Pallikaris, Aristofanis I. ;
Markomanolakis, Marinos ;
Yoo, Sonia H. .
JOURNAL OF CATARACT AND REFRACTIVE SURGERY, 2007, 33 (11) :1982-1984
[8]   Streptococcus salivarius meningitis after spinal anesthesia [J].
Laurila, JJ ;
Kostamovaara, PA ;
Alahuhta, S .
ANESTHESIOLOGY, 1998, 89 (06) :1579-1580
[9]   Bacteria commonly isolated from keratitis specimens retain antibiotic susceptibility to fluoroquinolones and gentamicin plus cephalothin [J].
Ly, CN ;
Pham, JN ;
Badenoch, PR ;
Bell, SM ;
Hawkins, G ;
Rafferty, DL ;
McClellan, KA .
CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY, 2006, 34 (01) :44-50
[10]  
Manikandan P., 2005, Indian Journal of Ophthalmology, V53, P59