RESUMO
PURPOSE: To present a case of infectious keratitis occurring 6 years after LASIK due to the rare human pathogen Shewanella putrefaciens. METHODS: A 58-year-old man presented with redness and pain in the right eye 6 years following LASIK retreatment. Examination revealed a corneal infiltrate at the flap interface. Corneal scraping of stroma beneath the flap was submitted for histopathologic and microbiologic evaluation. RESULTS: An infiltrate located at the LASIK flap interface originated from an epithelial defect at the flap-corneal junction. Corneal stroma cultures demonstrated Shewanella putrefaciens. The infection resolved with antibiotic treatment. CONCLUSIONS: LASIK-related complications, such as infections, can occur many years following the procedure. The potential space created under the LASIK flap may predispose patients to infection by opportunistic organisms.
Assuntos
Infecções Oculares Bacterianas/microbiologia , Infecções por Bactérias Gram-Negativas/microbiologia , Ceratite/microbiologia , Ceratomileuse Assistida por Excimer Laser In Situ , Complicações Pós-Operatórias , Shewanella putrefaciens/isolamento & purificação , Retalhos Cirúrgicos/microbiologia , Antibacterianos/uso terapêutico , Cefazolina/uso terapêutico , Substância Própria/microbiologia , Quimioterapia Combinada , Infecções Oculares Bacterianas/diagnóstico , Infecções Oculares Bacterianas/tratamento farmacológico , Infecções por Bactérias Gram-Negativas/diagnóstico , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Humanos , Ceratite/diagnóstico , Ceratite/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Reoperação , Tobramicina/uso terapêuticoRESUMO
BACKGROUND: ATL-146e, an adenosine A2A agonist, reduces paralysis after spinal cord ischemia-reperfusion. We hypothesized that systemic ATL-146e could improve neurologic outcome after blunt spinal cord trauma. METHODS: Twenty rabbits survived a thoracic spinal cord impact of 30 g-cm. One group received 0.06 microg/kg/min ATL-146e for the first 3 hours after impact (A2A group), whereas a second group received saline carrier (T/C group). Neurologic outcome was measured using the Tarlov scale (0-5). Histologic sections from the A2A and T/C groups were compared for neuronal viability. RESULTS: There was significant improvement in Tarlov scores of A2A animals compared with T/C animals at 12 hours (p = 0.007), with a trend toward improvement at 36 (p = 0.08) and 48 (p = 0.09) hours after injury. There was decreased neuronal attrition in A2A animals (p = 0.06). CONCLUSION: Systemic ATL-146e given after spinal cord trauma results in improved neurologic outcome. Adenosine A2A agonists may hold promise as a rapidly acting alternative to steroids in the early treatment of the spinal cord injured patient.
