Urrets-Zavalia Syndrome after Penetrating Keratoplasty: A Case Report

Urrets-Zavalia syndrome is a dreaded complication of anterior segment surgery and the most common in patients undergoing corneal transplantation. Avoiding the prescription of mydriatic eye drops during the postoperative period is the mainstay of its therapy, which focuses on prevention. One month after having keratoplasty in the left eye, a 42-year-old man presented with Urrets-Zavalia syndrome and ocular hypertonia at 35 mmgh. Medical and surgical management were required in this situation.The purpose of our presentation is to describe a real-world instance of Urrets-Zavalia syndrome.

Study of the genetic diversity of Moraxella spp. isolates obtained from corneal abscesses / Estudio de la diversidad genética de aislamientos de Moraxella spp. a partir de abscesos corneales

Abstract This is the first study of the genetic diversity of Moraxella spp. Isolates were detected in an Eye Hospital in the City of Buenos Aires. Due to the high frequency of Moraxella spp. observed in corneal abscesses, we decided to validate their identification at the species level, determine their drug susceptibility and perform molecular subtyping. Seventeen (17) isolates obtained from corneal abscesses were evaluated. The identification was carried out using a combination of biochemical tests and MALDI-TOF mass spectrometry. Of these isolates, 88.2% were identified as Moraxella lacunata, and 11.8% as Moraxella nonliquefaciens. Molecular subtyping was performed using the pulsed-field gel electrophoresis (PFGE) technique. All isolates were typable and thirteen digestion patterns were identified. Based on the obtained results, the PFGE technique using the SmaI enzyme can be used for epidemiological studies of strains of these species.

Resumen En este trabajo se presenta el primer estudio de diversidad genética de aislamientos de Moraxella spp. detectados en un hospital de oftalmología de la Ciudad Autónoma de Buenos Aires. Debido a la observación de una elevada frecuencia de Moraxella spp. en abscesos corneales, se decidió confirmar su identificación a nivel de especie, conocer su sensibilidad y realizar la subtipificación molecular. Se analizaron 17 aislamientos provenientes de abscesos corneales. La identificación se realizó mediante una combinación de pruebas bioquímicas y espectrometría de masas, MALDI-TOF MS. El 88,2% fueron identificados como Moraxella lacunata y el 11,8% como Moraxella nonliquefaciens. La subtipificación molecular se realizó por la técnica de electroforesis en gel de campo pulsado (PFGE). Todos los aislamientos fueron tipificables y se identificaron 13 patrones de digestión. Nuestros resultados muestran que la técnica de PFGE con la enzima SmaI es útil para hacer estudios epidemiológicos en cepas de estas especies.

Corneal Abscess on Mini-scleral Contact Lens: Clinical Case

Mini-scleral lens’ are large diameter rigid lenses that are used to rehabilitate vision when the corneal shape is distorted from disease, scarring or after a corneal graft procedure, however, there are relatively few reports regarding their potential complications, in this case we describe the case of a corneal abscess in a mini-scleral lens wearer with keratoconus in order to determine whether this type of contact lens presents an increased risk of infection.

Dolosigranulum pigrum en absceso corneal / Dolosigranulum pigrum in corneal abscess

Resumen Dolosigranulum pigrum es un coco gram positivo, anaerobio facultativo, que forma parte de la microbiota oral y del tracto respiratorio superior. Aunque los reportes de infecciones por este microorganismo son escasos, se lo ha asociado a un amplio espectro de enfermedades infecciosas. Se describe el caso de un hombre adulto con un absceso corneal del que se aisló D. pigrum. El microorganismo fue identificado por espectrometría de masas (MALDI-TOF MS) y secuenciación del gen 16S ARNr. A su vez, se logró la identificación presuntiva mediante pruebas fenotípicas claves, como la disposición en racimos en la coloración de Gram, la prueba negativa de la catalasa, la producción de pirrolidonil arilamidasa y leucina aminopeptidasa, el crecimiento en NaCl al 6,5% y la hidrólisis de esculina. Los datos de la literatura y el presente caso respaldan la asociación del microorganismo con infecciones oculares, a menudo de curso destructivo, principalmente en pacientes de edad avanzada.

Abstract Dolosigranulum pigrum is a gram-positive, facultatively anaerobic coccus, which is part of the oral and upper respiratory tract microbiota. Although reports of infections by this microorganism are scarce, it has been associated with a wide spectrum of infectious diseases. The case of an elderly man with a lower corneal abscess, in which Dolosigranulum pigrum was isolated, is described. The microorganism was identified by mass spectrometry (MALDI-TOF MS) and by the sequencingof the 16S rRNAgene. Furthermore, the presumptive identification of the causative agent was achieved by using key phenotypic tests such as the cluster arrangement in Gram stain, the negative catalase test, the production of pyrrolidonyl arylamidase and leucine aminopeptidase activity, the growth in 6.5% NaCl and esculin hydrolysis. The data from the literature (and the present case) support the association of the microorganism with ocular infections, which often take a destructive course, mainly in elderly patients.