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1.
Article in Korean | WPRIM | ID: wpr-926401

ABSTRACT

Background and Objectives@#Globus pharyngeus is one of the most common symptoms of patients visiting otorhinolaryngology out-patient clinic, and usually long-lasting, difficult to treat, and frequently recurrent. Mucomyst®, N-acetyl cysteine is an inhalation agent mainly used for mucolysis and reducing inflammation in airway via antioxidative effect. The purpose of this study was to evaluate the efficacy of inhaled Mucomyst® treatment in patients with globus pharyngeus refractory to proton pump inhibitor (PPI).Materials and Method We prospectively evaluated the efficacy of Mucomyst® in relieving symptoms of globus pharyngeus refractory to PPI in nine medical centers. Three hundred and three patients enrolled and finally 229 patients finished the inhaled Mucomyst® therapy for 8 weeks. We analyzed the change of Reflux Symptom Index (RSI), Reflux Finding Score (RFS), Visual Analogue Scale (VAS) for globus, and Globus Pharyngeus Symptom Scale (GPS) after use of Mucomyst® for 4 and 8 weeks. @*Results@#The GPS, RSI, RFS, and VAS score significantly decreased serially in patients who finished 8 week-inhalation treatment. The GPS improvement gap was significantly correlated with initial GPS (p<0.001) in multiple regression analysis. @*Conclusion@#Inhaled Mucomyst® therapy was effective for the reduction of both subjective and objective findings in refractory globus patients. This study might suggest new treatment option for patients with globus. However, further thorough studies would be needed to assess the real effect of inhaled Mucomyst® treatment as a standard treatment for globus.

2.
Epidemiology and Health ; : e2021019-2021.
Article in English | WPRIM | ID: wpr-890620

ABSTRACT

OBJECTIVES@#Recurrent respiratory papillomatosis (RRP) is caused by human papillomavirus (HPV) types 6 and 11 and is potentially preventable through vaccination. This study estimated the incidence of juvenile-onset RRP before the implementation of the national HPV vaccination program in Korea. @*METHODS@#We conducted a cohort study using claims data provided by a mandatory insurance program to estimate the incidence of RRP and associated healthcare use. Patients with juvenile RRP were defined as those aged ≤12 years with ≥2 admissions or ≥2 outpatient visits during which they received the International Classification of Diseases, 10th revision code for benign neoplasms of the larynx (D14.1). @*RESULTS@#During 2002-2014, 123 children (74 boys and 49 girls) were diagnosed with RRP. The patients had a mean of 6.5 person-years of follow-up. The incidence was estimated at 0.30/100,000 person-years. The median age at diagnosis was 4.0 years (mean, 4.3). Thirty-six (29.3%) patients underwent surgery, including 23 patients (18.7%) who underwent 2 or more surgical procedures. Severe disease, measured by more frequent surgical procedures and shorter time intervals between consecutive operations, was associated with a younger age at diagnosis. @*CONCLUSIONS@#The estimated incidence of juvenile-onset RRP in Korea was similar to that reported in other countries. The RRP burden should continue to be monitored using National Health Insurance Service claims data.

3.
Article in Korean | WPRIM | ID: wpr-875064

ABSTRACT

Purpose@#To investigate the resistance rate of Enterococcus faecalis which is one of the causative strains of endophthalmitis to three fluoroquinolone drugs, the quinolone resistance gene mutation patterns, and the presence of virulence factor genes. @*Methods@#Between April 1, 2014, and January 16, 2018, 416 eyes of 208 patients undergoing cataract surgery, intravitreal injection, or vitrectomy were examined to identify conjunctival commensals. Patients with infective keratitis and infective endophthalmitis were also examined for the presence of E. faecalis. Before the procedure and surgery, samples for identification of conjunctival commensals were collected from the lower conjunctival sac of both eyes. In addition, corneal and vitreous specimens were collected from patients with keratitis and endophthalmitis, respectively. E. faecalis isolated by culturing the samples was tested for drug susceptibility, the presence of gene sequence mutations, and virulence factor genes. @*Results@#In total, 342 strains were identified in samples from the conjunctiva and included six isolates of E. faecalis. The study was conducted with a total of 16 isolates of E. faecalis, including two from cases of keratitis and eight from cases of endophthalmitis. Six of the 16 strains (37.5%) were resistant to quinolone antibiotics. Point mutations were detected mainly in gyrA and parC. The virulence factors esp, efba, asa1, ace, cylA, and gelE were present in the strains and showed no differences between the quinolone-resistant and quinolone-sensitive strains. Gelatinase activity test was negative for all strains. @*Conclusions@#The resistance rate of enterococcal clinical isolates identified in the ocular area was 37.5%. The increase in resistance to quinolone antibiotics seems to be related to the presence of mutations in gyrA and parC genes. E. faecalis identified in the eye is thought to possess the virulence factors genes esp, efba, asa1, ace, cylA, and gelE.

4.
Article in Korean | WPRIM | ID: wpr-875045

ABSTRACT

Purpose@#We report surgical repair of an abnormally attached lateral rectus muscle in a sensory exotropia patient.Case summary: A 21-year-old man visited our hospital with lateral deviation in the right eye. The patient had a history of trauma (11 years previously) to the right eye, which showed 30 prism diopters of exotropia. In accordance with a diagnosis of sensory exotropia, 7.5-mm lateral rectus muscle recession and 6-mm medial rectus muscle resection were planned in the right eye. During surgery, the lateral rectus muscle was inserted into the sclera at a distance of 12 mm from the corneal limbus. To compensate for this, the lateral rectus muscle was recessed with an adjustable suture. After surgery, the patient showed 8-10 prism diopters of exotropia. A 2-mm recession was achieved by suturing. After surgery, the patient did not show exotropia, while after 3 months of follow-up the patient showed about 4 prism diopters of esotropia. @*Conclusions@#Despite abnormal attachment of an extraocular muscle, it is possible to obtain a good cosmetic result if the surgery is performed according to the preoperative plan. Suturing can be helpful if the surgical field is difficult to secure during the surgery.

5.
Article in English | WPRIM | ID: wpr-901361

ABSTRACT

Cervicovaginal venous malformations are extremely rare. Sclerotherapy is proven to be effective for superficial venous malformations but not for venous malformations in the lower genital tract of female. A 52-year-old female presented with intermittent vaginal bleeding. The amount of vaginal bleeding gradually increased over 3 months. Contrast-enhanced pelvis CT showed several phleboliths and dilated vessels, but pelvic angiography showed no early draining veins, nidus, or feeding artery. We performed transvaginal direct puncture and ethanol sclerotherapy rather than surgical treatment because she wanted to preserve the uterus. After four sessions of sclerotherapy, she had significantly decreased vaginal bleeding without complications. Here, we report the first case of cervicovaginal venous malformations successfully treated with transvaginal direct puncture and ethanol sclerotherapy.

6.
Article in Korean | WPRIM | ID: wpr-901120

ABSTRACT

Purpose@#To report the first case of Curtobacterium endophthalmitis within 6 hours after open globe injury, with extensive phlebitis and secondary subretinal neovascularization. Case summary: A 53-year-old man with hypersensitivity to beta-lactam antibiotics was admitted due to visual disturbance in the left eye experienced while working in a rural area. Fundus examination was impossible due to a full-layer corneal laceration and traumatic cataract in the left eye. B-scan ultrasonography and orbital computed tomography showed no shadowing of retained intraocular foreign bodies. After a corneal scraping smear, primary closure, lensectomy, and vitrectomy were performed. Organic material was observed in a focal area of pale macula, accompanied by extensive retinal phlebitis in the mid-periphery. After diagnosing acute bacterial endophthalmitis, intravitreal vancomycin and dexamethasone were injected. Curtobacterium pusillum was cultured on an automated microbial identification system. Intravenous vancomycin and oral clarithromycin were administered for 2 weeks. After 3 months, endophthalmitis had not recurred, and the visual acuity reached 20/100. However, subretinal neovascularization was newly detected under the damaged macula. No complications of neovascularization were observed until 6 months after primary closure. @*Conclusions@#Curtobacterium pusillum can induce acute endophthalmitis through direct penetration in cases of ocular trauma, and may be accompanied by extensive phlebitis and secondary subretinal neovascularization. In cases of open globe injury sustained in rural areas, acute endophthalmitis caused by a rare Gram-positive bacillus, such as Curtobacterium species, should be considered.

7.
Article in Korean | WPRIM | ID: wpr-901032

ABSTRACT

Purpose@#To investigate the effects of intravitreal bevacizumab injection combined with laser photocoagulation in patients with retinal microaneurysms. @*Methods@#We retrospectively reviewed the medical records of 21 eyes of 21 patients who underwent intravitreal bevacizumab injection and/or laser photocoagulation to treat retinal macroaneurysms. Eleven eyes received the combination therapy (CT) and 10 eyes monotherapy (MT) (either bevacizumab injection or laser photocoagulation). Changes in visual acuity, central macular thickness, macroaneurysm size and location, blood pressure, and the lipid level were compared between the two groups. @*Results@#The mean patient age was 74.0 ± 10.5 years and the mean study period 7.0 ± 5.3 months. The mean macroaneurysm diameter of the CT group was 480.00 ± 292.30 μm and that of the MT group 328.75 ± 87.09 μm. The diameter was significantly larger in the CT group (p = 0.002). The initial visual acuities were 0.91 ± 0.66 and 0.88 ± 0.83 in the CT and MT groups, respectively. At the 4-month follow-up, the visual acuities were 0.33 ± 0.26 and 0.17 ± 0.29 in the CT and MT groups, respectively, and had significantly improved only in the CT group (p = 0.042). The initial central macular thicknesses were 441.82 ± 226.81 and 541.63 ± 401.97 μm in the CT and MT groups, respectively. At the 4-month follow-up, the figures were 293.60 ± 46.10 and 269.00 ± 48.34 μm in the CT and MT groups, respectively, and had significantly decreased only in the CT group (p = 0.043). Compared to the initial findings, the proportion of patients whose final visual acuities improved by more than two lines were 73% and 40%, respectively, thus significantly higher in the CT group (p < 0.001). @*Conclusions@#Combined intravitreal bevacizumab injection and laser photocoagulation treatment of retinal macroaneurysms improve visual acuity and decrease macular thickness.

8.
Epidemiology and Health ; : e2021019-2021.
Article in English | WPRIM | ID: wpr-898324

ABSTRACT

OBJECTIVES@#Recurrent respiratory papillomatosis (RRP) is caused by human papillomavirus (HPV) types 6 and 11 and is potentially preventable through vaccination. This study estimated the incidence of juvenile-onset RRP before the implementation of the national HPV vaccination program in Korea. @*METHODS@#We conducted a cohort study using claims data provided by a mandatory insurance program to estimate the incidence of RRP and associated healthcare use. Patients with juvenile RRP were defined as those aged ≤12 years with ≥2 admissions or ≥2 outpatient visits during which they received the International Classification of Diseases, 10th revision code for benign neoplasms of the larynx (D14.1). @*RESULTS@#During 2002-2014, 123 children (74 boys and 49 girls) were diagnosed with RRP. The patients had a mean of 6.5 person-years of follow-up. The incidence was estimated at 0.30/100,000 person-years. The median age at diagnosis was 4.0 years (mean, 4.3). Thirty-six (29.3%) patients underwent surgery, including 23 patients (18.7%) who underwent 2 or more surgical procedures. Severe disease, measured by more frequent surgical procedures and shorter time intervals between consecutive operations, was associated with a younger age at diagnosis. @*CONCLUSIONS@#The estimated incidence of juvenile-onset RRP in Korea was similar to that reported in other countries. The RRP burden should continue to be monitored using National Health Insurance Service claims data.

9.
Article in English | WPRIM | ID: wpr-893657

ABSTRACT

Cervicovaginal venous malformations are extremely rare. Sclerotherapy is proven to be effective for superficial venous malformations but not for venous malformations in the lower genital tract of female. A 52-year-old female presented with intermittent vaginal bleeding. The amount of vaginal bleeding gradually increased over 3 months. Contrast-enhanced pelvis CT showed several phleboliths and dilated vessels, but pelvic angiography showed no early draining veins, nidus, or feeding artery. We performed transvaginal direct puncture and ethanol sclerotherapy rather than surgical treatment because she wanted to preserve the uterus. After four sessions of sclerotherapy, she had significantly decreased vaginal bleeding without complications. Here, we report the first case of cervicovaginal venous malformations successfully treated with transvaginal direct puncture and ethanol sclerotherapy.

10.
Article in Korean | WPRIM | ID: wpr-893416

ABSTRACT

Purpose@#To report the first case of Curtobacterium endophthalmitis within 6 hours after open globe injury, with extensive phlebitis and secondary subretinal neovascularization. Case summary: A 53-year-old man with hypersensitivity to beta-lactam antibiotics was admitted due to visual disturbance in the left eye experienced while working in a rural area. Fundus examination was impossible due to a full-layer corneal laceration and traumatic cataract in the left eye. B-scan ultrasonography and orbital computed tomography showed no shadowing of retained intraocular foreign bodies. After a corneal scraping smear, primary closure, lensectomy, and vitrectomy were performed. Organic material was observed in a focal area of pale macula, accompanied by extensive retinal phlebitis in the mid-periphery. After diagnosing acute bacterial endophthalmitis, intravitreal vancomycin and dexamethasone were injected. Curtobacterium pusillum was cultured on an automated microbial identification system. Intravenous vancomycin and oral clarithromycin were administered for 2 weeks. After 3 months, endophthalmitis had not recurred, and the visual acuity reached 20/100. However, subretinal neovascularization was newly detected under the damaged macula. No complications of neovascularization were observed until 6 months after primary closure. @*Conclusions@#Curtobacterium pusillum can induce acute endophthalmitis through direct penetration in cases of ocular trauma, and may be accompanied by extensive phlebitis and secondary subretinal neovascularization. In cases of open globe injury sustained in rural areas, acute endophthalmitis caused by a rare Gram-positive bacillus, such as Curtobacterium species, should be considered.

11.
Article in Korean | WPRIM | ID: wpr-893328

ABSTRACT

Purpose@#To investigate the effects of intravitreal bevacizumab injection combined with laser photocoagulation in patients with retinal microaneurysms. @*Methods@#We retrospectively reviewed the medical records of 21 eyes of 21 patients who underwent intravitreal bevacizumab injection and/or laser photocoagulation to treat retinal macroaneurysms. Eleven eyes received the combination therapy (CT) and 10 eyes monotherapy (MT) (either bevacizumab injection or laser photocoagulation). Changes in visual acuity, central macular thickness, macroaneurysm size and location, blood pressure, and the lipid level were compared between the two groups. @*Results@#The mean patient age was 74.0 ± 10.5 years and the mean study period 7.0 ± 5.3 months. The mean macroaneurysm diameter of the CT group was 480.00 ± 292.30 μm and that of the MT group 328.75 ± 87.09 μm. The diameter was significantly larger in the CT group (p = 0.002). The initial visual acuities were 0.91 ± 0.66 and 0.88 ± 0.83 in the CT and MT groups, respectively. At the 4-month follow-up, the visual acuities were 0.33 ± 0.26 and 0.17 ± 0.29 in the CT and MT groups, respectively, and had significantly improved only in the CT group (p = 0.042). The initial central macular thicknesses were 441.82 ± 226.81 and 541.63 ± 401.97 μm in the CT and MT groups, respectively. At the 4-month follow-up, the figures were 293.60 ± 46.10 and 269.00 ± 48.34 μm in the CT and MT groups, respectively, and had significantly decreased only in the CT group (p = 0.043). Compared to the initial findings, the proportion of patients whose final visual acuities improved by more than two lines were 73% and 40%, respectively, thus significantly higher in the CT group (p < 0.001). @*Conclusions@#Combined intravitreal bevacizumab injection and laser photocoagulation treatment of retinal macroaneurysms improve visual acuity and decrease macular thickness.

12.
Article in Korean | WPRIM | ID: wpr-900939

ABSTRACT

Purpose@#To report a patient with relentless placoid chorioretinitis who showed recurrent multiple placoid lesions and retinal pigment epithelial atrophic changes in both eyes for more than 16 months.Case summary: A 21-year-old man visited our clinic because of visual disturbance in both eyes. The best-corrected visual acuities were 20/50 and 20/20 in the right and left eyes, respectively. The fundus showed multiple whitish placoid lesions from the posterior pole to the mid-periphery. There were no anterior chamber inflammation signs. To exclude systemic and infectious etiologies, laboratory workup was performed. All tests were negative except for the serological types HLAB13 and B51. Based on clinical estimation, we made a diagnosis of acute posterior multifocal placoid pigment epitheliopathy or posterior uveitis and prescribed oral methylprednisolone for the patient. However, multiple white dot lesions occurred repeatedly in both eyes for 7 months. With the oral methylprednisolone and immunosuppressive treatment, the best-corrected visual acuity of both eyes was maintained at 20/20 without further recurrence 16 months after the first visit. The lesions left atrophic findings in the retinal pigment epithelium. We diagnosed the patient with relentless placoid chorioretinitis, based on the prolonged clinical course and widespread lesion distribution. @*Conclusions@#Relentless placoid chorioretinitis should be considered in patients with chronically progressive multiple white dot lesions and retinal pigment epithelium atrophic changes between the central pole and the periphery. Aggressive immunosuppressive treatment should be performed to improve the patient's visual outcome.

13.
Article in Korean | WPRIM | ID: wpr-893235

ABSTRACT

Purpose@#To report a patient with relentless placoid chorioretinitis who showed recurrent multiple placoid lesions and retinal pigment epithelial atrophic changes in both eyes for more than 16 months.Case summary: A 21-year-old man visited our clinic because of visual disturbance in both eyes. The best-corrected visual acuities were 20/50 and 20/20 in the right and left eyes, respectively. The fundus showed multiple whitish placoid lesions from the posterior pole to the mid-periphery. There were no anterior chamber inflammation signs. To exclude systemic and infectious etiologies, laboratory workup was performed. All tests were negative except for the serological types HLAB13 and B51. Based on clinical estimation, we made a diagnosis of acute posterior multifocal placoid pigment epitheliopathy or posterior uveitis and prescribed oral methylprednisolone for the patient. However, multiple white dot lesions occurred repeatedly in both eyes for 7 months. With the oral methylprednisolone and immunosuppressive treatment, the best-corrected visual acuity of both eyes was maintained at 20/20 without further recurrence 16 months after the first visit. The lesions left atrophic findings in the retinal pigment epithelium. We diagnosed the patient with relentless placoid chorioretinitis, based on the prolonged clinical course and widespread lesion distribution. @*Conclusions@#Relentless placoid chorioretinitis should be considered in patients with chronically progressive multiple white dot lesions and retinal pigment epithelium atrophic changes between the central pole and the periphery. Aggressive immunosuppressive treatment should be performed to improve the patient's visual outcome.

14.
Article in English | WPRIM | ID: wpr-786335

ABSTRACT

PURPOSE: We investigated structural changes in the retina by using optical coherence tomography (OCT) in a feline model of retinal degeneration using iodoacetic acid (IAA).METHODS: We examined 22 eyes of 11 felines over 2 years of age. The felines had fasted for 12 hours and were intravenously injected with IAA 20 mg/kg of body weight. OCT (Spectralis OCT) was performed at the point where the ends of the retinal vessels collected in the lateral direction from the optic nerve head and area centralis. Similarly, OCT was performed four times at 1-week intervals following injections, at which point the felines were sacrificed and histologic examinations were performed. Using OCT, the thickness of each layer of the retina was measured.RESULTS: The average body weight of the three male and eight female felines investigated in this study was 1.61 ± 0.19 kg. The mean total retinal thickness of the felines before injection was 221.32 ± 9.82 µm, with a significant decrease in the retinal thickness at 2, 3, and 4 weeks following injections of 186.41 ± 35.42, 174.56 ± 31.94, and 175.35 ± 33.84 µm, respectively (p = 0.028, 0.027, and 0.027, respectively). The thickness of the outer nuclear layer was 57.49 ± 8.03 µm before injection and 29.26 ± 17.87, 25.62 ± 13.88, and 31.60 ± 18.38 µm at 2, 3, and 4 weeks, respectively, after injection (p = 0.028, 0.028, 0.046, respectively).CONCLUSIONS: In a feline model of retinal degeneration using IAA, the total retinal thickness and the thickness of the outer nuclear layer were shown to decrease significantly on OCT.


Subject(s)
Angiography , Body Weight , Female , Humans , Iodoacetic Acid , Male , Optic Disk , Photoreceptor Cells, Vertebrate , Retina , Retinal Degeneration , Retinal Vessels , Retinaldehyde , Tomography, Optical Coherence
15.
Article in Korean | WPRIM | ID: wpr-766850

ABSTRACT

PURPOSE: To investigate the changes of visual acuity and central macular thickness (CMT) in patients with diabetic retinopathy (DR) receiving long-term hemodialysis (HD). METHODS: From January 1, 2008, to December 31, 2018, the medical records of patients who were diagnosed with DR receiving HD three times a week for ≥18 months due to chronic kidney disease (CKD) were analyzed. Among them, patients diagnosed with DR 6 months before the start of HD were included. Patients with vitreous hemorrhage (VH) affecting visual acuity (VA), other retinal diseases, and cataract surgery after HD were excluded. The VA and CMT before HD and at 1, 3, 6, 12, and 18 months after HD were analyzed. RESULTS: Of the 222 eyes of 111 patients who were diagnosed with DR and received HD for CKD due to diabetes, 174 eyes with DR diagnosed after starting HD were excluded. Ten eyes with VH before starting HD, two eyes with epiretinal membrane, and four eyes with cataract surgery after starting HD were also excluded. Thirty-two eyes of 18 patients were included. The mean age of the patients was 53.71 ± 9.25 years. Twenty-four males and eight female patients were included in the study. The mean logMAR VA improved significantly from 0.36 ± 0.28 before starting HD to 0.26 ± 0.27 at 18 months after starting HD (p = 0.002). The mean CMT was significantly decreased from 307.12 ± 89.52 µm before starting HD to 279.71 ± 61.75 µm at 12 months after starting HD (p = 0.02). CONCLUSIONS: In patients with DR who underwent long-term HD, CMT decreased and VA improved, when compared with these parameters before HD.


Subject(s)
Cataract , Diabetic Retinopathy , Epiretinal Membrane , Female , Humans , Macular Edema , Male , Medical Records , Renal Dialysis , Renal Insufficiency, Chronic , Retinal Diseases , Visual Acuity , Vitreous Hemorrhage
18.
Article in Korean | WPRIM | ID: wpr-916366

ABSTRACT

PURPOSE@#We explored changes in photoreceptor function and histology in an iodoacetic acid (IAA)-induced model of feline retinal degeneration.@*METHODS@#From January to October 2014, we studied 11 adult felines (22 eyes) over 2 years of age divided into two groups (two in a control and nine in an IAA group). The mean body weights of these two groups were 1.75 ± 0.35 and 1.61 ± 0.19 kg, and the male:female sex ratios 1:1 and 2:7, respectively. Electroretinograms (ERGs) were obtained before injection and at 1–4 week post-injection (20 mg/kg IAA). Standard paraffin retinal sections were stained with hematoxylin/eosin and other sections subjected to immunohistochemistry. We histologically evaluated the outer nuclear layer, and photoreceptor cone and rod cells.@*RESULTS@#In ERGs of the IAA group, both the rod and cone mean b wave amplitudes decreased significantly from week 1 to week 4 after injection (27.43, 29.41, 64.17, and 56.03; and 61.04, 51.25, 131.36, and 136.68 µV, respectively) compared to baseline (322.48 and 610.00 µV respectively) (p < 0.01). Optical microscopy revealed a significant decrease in the cell count of the outer nuclear retinal layer (16.83 ± 0.89 in the control and 11.98 ± 3.55 in the IAA groups, p < 0.01). Fluorescence microscopy revealed a significant reduction in the mean area per unit length of the rod cell layer (35,225.67 ± 2,477.02 and 14,903.62 ± 2,319.65 in the control and IAA groups, p < 0.01), but not in the cone cell count (26.16 ± 1.34 and 23.98 ± 6.16 in the control and IAA groups, p = 0.075).@*CONCLUSIONS@#ERGs revealed that functional b wave amplitudes fell after IAA-induce retinal degeneration in felines; histology showed that this was accompanied by reductions in the numbers of outer nuclear layers and rod cells. IAA induces photoreceptor degeneration in felines; further study is necessary.

19.
Article in Korean | WPRIM | ID: wpr-738628

ABSTRACT

PURPOSE: To report polymicrobial keratitis involving Pseudomonas aeruginosa, Acinetobacter baumannii, and Ochrobactrum anthropi. CASE SUMMARY: A 53-year-old female complained of pain and secretion in her right eye, which started 6 weeks before her visit. She applied steroid ointment, which was received from the dermatologist, to her eyelid 7 days prior to her visit but this treatment worsened her symptoms. At the initial visit, the visual acuity of the right eye was light perception, and purulent secretions were observed. Using a slit lamp, severe conjunctival hyperemia, hypopyon, and a ring-shaped central corneal ulcer were observed. The anterior chamber and fundus were not observed due to corneal lesions but ultrasonography showed no intraocular inflammation. Infectious keratitis was suspected and cultured by corneal scraping. During the incubation period, 0.5% moxifloxacin, 2% voriconazole, and 1% cyclopentolate were administered. A total of 400 mg of moxifloxacin and 100 mg of doxycycline were given orally. In the primary culture, Pseudomonas aeruginosa and Acinetobacter baumannii were identified so 5% ceftazidime, which was sensitive for the antibiotic susceptibility results was further instilled. Thereafter, the keratitis improved but the keratitis again worsened while maintaining the topical treatment. A secondary culture was positive for Ochrobactrum anthropi. Treatment with 1.4% gentamicin, which was sensitive for the antibiotic susceptibility test was added and the keratitis improved. A conjunctival flap was performed because of the increased risk of perforation. CONCLUSIONS: We report polymicrobial keratitis involving Pseudomonas aeruginosa, Acinetobacter baumannii, and Ochrobactrum anthropi for the first time in the Republic of Korea.


Subject(s)
Acinetobacter baumannii , Acinetobacter , Anterior Chamber , Ceftazidime , Corneal Ulcer , Cyclopentolate , Doxycycline , Eyelids , Female , Gentamicins , Humans , Hyperemia , Inflammation , Keratitis , Middle Aged , Ochrobactrum anthropi , Ochrobactrum , Pseudomonas aeruginosa , Pseudomonas , Republic of Korea , Slit Lamp , Ultrasonography , Visual Acuity , Voriconazole
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