Diagnostics and Treatment of Polymicrobial Keratitis and Endophthalmitis-Case Report
|Nada Jirasková1,6, Vladimir Buchta2,6, Dimitar HadÅ¾i Nikolov3,6, Marcela Vejsová2,6, Pavel Rozsíval1,6 and Jan Lešták4,5,6*|
|1Department of Ophthalmology, University Hospital and Charles University Medical Faculty, Hradec Králové, Czech Republic|
|2Department of Clinical Microbiology, University Hospital and Charles University Medical Faculty, Hradec Králové, Czech Republic|
|3Fingerland Department of Pathology, University Hospital and Charles University Medical Faculty, Hradec Králové, Czech Republic|
|4JL Clinic, V Hurkách 1296/10, Prague, Czech Republic|
|5Czech Technical University in Prague, Faculty of Biomedical Engineering, Czech Republic|
|6Charles University, Faculty of Medicine in Hradec Kralove, Czech Republic|
|Corresponding Author :||Jan Lešták
JL Clinic, V Hurkách 1296/10
Prague, Czech Republic
E-mail: [email protected]
|Received June 13, 2013; Accepted September 02, 2013; Published September 09, 2013|
|Citation: Jirasková N, Buchta V, Nikolov DH, Vejsová M, Rozsíval P, et al. (2013) Diagnostics and Treatment of Polymicrobial Keratitis and Endophthalmitis–Case Report. J Clin Cell Immunol 4:162. doi:10.4172/2155-9899.1000162|
|Copyright: © 2013 Jirasková N, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
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Purpose: To describe a case of polymicrobial keratitis and endophthalmitis successfully treated with topical and systemic antibacterial and antifungal agents, collagen cross-linking (CXL) and penetrating keratoplasty.
Methods: Case report
Results: A 59-year-old woman presented with a corneal ulcer. Multiple samplings of the corneal lesion were used for microbiological investigations by standard protocol that repeatedly revealed coagulase-negative Staphylococcus sp. (CoNS); mycotic tests were negative. She was treated with topical and systemic antibiotics and an emergency therapeutic keratoplasty was performed. Four months later, she was readmitted for ulcerative keratitis and endophthalmitis. Laboratory work up on corneal corneal scraping and aqueous humor cultures showed a Fusarium species, CoNS and Bacillus species. She was treated with topical and systemic voriconazole, antibacterials, and the corneal cross-linking (CXL) procedure. Complete resolution of the infection was observed but a large vascular leucoma developed. A penetrating keratoplasty and anterior segment reconstruction surgery with very good results were performed seven months later.
Conclusions: Voriconazole, antibacterial antibiotics and CXL were effective in the management of a severe polymicrobial corneal ulcer progressing to endophthalmitis with no side-effects observed.