Multiorganism, drug-resistant keratitis treated by corneal crosslinking.

Abstract:

PURPOSE:To describe a case of multiorganism, drug-resistant keratitis that responded well to corneal crosslinking (CXL) treatment. METHODS:A 52-year-old man presented to our institute with a 2-month ocular history of infectious keratitis in his right eye, on topical antibacterial, antifungal, and antiprotozoan treatment, and complained of increase in pain, discomfort, and visual deterioration. Slit-lamp examination revealed advanced infectious keratitis (extensive deep corneal infiltrate with perineuritis). Cultural and molecular analysis of obtained corneal specimens demonstrated combined fungal and Acanthamoeba infection; confocal microscopy confirmed Acanthamoeba infection. Intense targeted topical antifungal and antiprotozoan treatment was initiated immediately and 1 month later CXL was performed due to drug resistance of the infection. RESULTS:Two weeks after CXL treatment, the corneal findings had deteriorated, while a corneal abscess was formed and extended at almost half of the cornea. This was gradually limited and the corneal infiltrate and abscess were eventually decreased. In addition, the symptoms improved. CONCLUSIONS:Corneal crosslinking could be an effective therapy in the management of advanced infectious keratitis unresponsive to conventional medical treatment.

journal_name

Eur J Ophthalmol

authors

Kymionis GD,Kouroupaki AI,Liakopoulos DA,Arandjelovic IR,Tsoulnaras KI

doi

10.5301/ejo.5000755

subject

Has Abstract

pub_date

2016-07-01 00:00:00

pages

e67-e70

issue

4

eissn

1120-6721

issn

1724-6016

pii

81E40C52-5CDD-4D5F-AE5C-A1E10199C611

journal_volume

26

pub_type

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