Infectious crystalline keratopathy post-Descemet stripping endothelial keratoplasty

We report a case of a 46-year-old female who developed infectious crystalline keratopathy (ICK) after Descemet's stripping endothelial keratoplasty (DSEK). She underwent DSEK for pseudophakic corneal edema in her left eye. Ten weeks after the procedure, the patient presented with complaints of blurred vision, redness in eye, and ocular pain. Slit lamp examination revealed white nonsuppurative branching deep stromal infiltrate. Microscopic examination of the Gram-stained smear showed gram-positive cocci. Streptococcus viridans was isolated on cultures. Isolated organism was sensitive to linezolid. Based on antibiotic sensitivity report, fortified linezolid (0.2%) eye drop was started on hourly basis. After 10 weeks of topical fortified linezolid (0.2%) therapy, complete resolution of infiltrate with significant corneal scarring and vascularization was seen. Infectious crystalline keratopathy can occur after DSEK.

Microbiology and antibiotic sensitivity of odontogenic space infection.

Background: Dental infections, including gingivitis, odontogenic infections periodontitis, dental caries and, result in frequent dental visits. Infection can be mild buccal space infection or severe life threatening multi space infection. Objectives: To appraise causative microorganisms responsible for odontogenic space infections and to evaluate sensitivity and resistance to antibiotics used in the treatment. Materials and Methods: 90 patients with orofacial space infections were considered. Pus samples were collected with aseptic precautions and examined in the department of microbiology for culture and antibiotic sensitivity. Results: Aerobic organisms were highly sensitive to Ceftriaxone 95.2%, Levofloxacin 90.5% and Amoxicillin and Clavulanic acid for 81% and were resistance to Ampicillin and Cefaclor 47.6%. Anaerobic organisms were 100% resistance to Ampicillin and were 100% sensitive to Cephalothin, Cephalexin, Gatifloxacin, Linezolid and Tazact. 91.7% were sensitive to Amoxicillin and Clavulanic acid. Ampicillin resistance was seen in 47.6% of aerobes and 100% of the anaerobes. Conclusion: This study confirms that the microbiological flora of odontogenic infections consists of complex mixture of aerobic and anaerobic bacteria. The microorganisms isolated were Streptococcus viridians, Klebsiella, Pseudomonas Aeruginosa, and Coagulase negative Staphylococci. Most common anaerobic organisms were Peptococci and Peptostreptococci. Amoxicillin/clavulunic acid and Cefotaxime were most effective antibiotics.