ABSTRACT
We report a case of mixed Aspergillus fumigatus and coagulase-negative Staphylococcus stromal keratitis in a 43-year-old man who developed discomfort and swelling in his right eye 20 days after uneventful bilateral laser in situ keratomileusis (LASIK). Clinical examination revealed 2 distinct corneal infiltrates beneath the LASIK flap. Corneal scrapings were taken for microscopic examination and culture. Both infiltrates initially improved on topical antibiotic therapy, but over the next 18 days, 1 infiltrate worsened and repeat cultures were performed, which demonstrated A fumigatus. Natamycin 5% and amphotericin 0.1% were started and continued for 8 weeks with resolution of the infiltrate and return of the best corrected visual acuity. Delayed-onset multifocal keratitis is a rare complication of LASIK. Fungal entities should be considered in the differential diagnosis.
Subject(s)
Aspergillosis/etiology , Aspergillus fumigatus/isolation & purification , Eye Infections, Bacterial/etiology , Eye Infections, Fungal/etiology , Keratitis/microbiology , Keratomileusis, Laser In Situ/adverse effects , Staphylococcal Infections/etiology , Staphylococcus/isolation & purification , Adult , Amphotericin B/therapeutic use , Anti-Bacterial Agents/therapeutic use , Antifungal Agents/therapeutic use , Aspergillosis/drug therapy , Eye Infections, Bacterial/drug therapy , Eye Infections, Fungal/drug therapy , Humans , Keratitis/drug therapy , Male , Natamycin/therapeutic use , Staphylococcal Infections/drug therapyABSTRACT
PURPOSE: To report a case of Gemella hemolysans keratitis with consecutive endophthalmitis. METHODS: Interventional case report. A 47-year-old woman with a history of sarcoidosis treated chronically with systemic prednisone developed bacterial keratitis and consecutive endophthalmitis in the left eye. RESULTS: Corneal, aqueous, and vitreous cultures yielded G. hemolysans. Emergent keratoplasty, pars plana vitrectomy, and injection of intravitreal antibiotics led to resolution of the infection and improved vision. Five months after surgery, the corneal graft has remained clear since cessation of antibiotics. CONCLUSION: This is the first report, to our knowledge, of ocular G. hemolysans infection, an uncommon gram-positive pathogen often confused with viridans-type streptococci.
