RESUMEN
Purpose: To report a case of atypical keratitis caused by Rothia dentocariosa.Methods: Retrospective case review.Results: A 49 year-old woman of South Asian descent presented with a non-discrete corneal ulcer with a small overlying epithelial defect in the right eye. Cultures were obtained, a topical fluoroquinolone was continued, and a topical steroid was added. The following day, the infiltrate was noted to have worsened and developed a branching appearance. Antifungals were initiated. The culture grew Rothia dentocariosa. A series of intrastromal cefuroxime injections, followed by topical penicillin G drops, led to complete resolution within 8 weeks. A review of the literature revealed only one previously reported case of Rothia dentocariosa keratitis.Conclusions: Rothia dentocariosa may cause an atypical keratitis requiring a prolonged treatment course for resolution. In our case, a combination of cefuroxime and penicillin was effective.
Asunto(s)
Córnea/microbiología , Infecciones Bacterianas del Ojo/microbiología , Infecciones por Bacterias Grampositivas/microbiología , Queratitis/microbiología , Micrococcaceae/aislamiento & purificación , Agudeza Visual , Antibacterianos/uso terapéutico , Córnea/patología , Infecciones Bacterianas del Ojo/diagnóstico , Infecciones Bacterianas del Ojo/tratamiento farmacológico , Femenino , Infecciones por Bacterias Grampositivas/diagnóstico , Infecciones por Bacterias Grampositivas/tratamiento farmacológico , Humanos , Queratitis/diagnóstico , Queratitis/tratamiento farmacológico , Persona de Mediana EdadRESUMEN
A 64-year-old Caucasian man had been diagnosed with presumed ocular surface squamous neoplasia in the left eye and started on topical interferon alpha 2b drops. When we saw him, he provided a history of penetrating corneal injury more than forty years before. Slit lamp examination revealed a large, elevated, opaque lesion involving the left cornea. High-definition anterior segment optical coherence tomography revealed a hyperreflective lesion involving the anterior stroma with a relatively normal overlying epithelium. Based on the clinical history, slit lamp, and anterior segment optical coherence tomography findings, a giant corneal keloid was suspected, and the interferon drops were discontinued. He subsequently underwent a penetrating keratoplasty, and histopathologic analysis was consistent with corneal keloid. Corneal keloids may be seen decades after the initial trauma, and anterior segment optical coherence tomography can be a useful tool in differentiating these tumor-like lesions from other neoplasia.
Asunto(s)
Córnea/patología , Enfermedades de la Córnea/etiología , Lesiones Oculares Penetrantes/complicaciones , Queloide/etiología , Córnea/cirugía , Enfermedades de la Córnea/diagnóstico , Enfermedades de la Córnea/cirugía , Humanos , Queloide/diagnóstico , Queloide/cirugía , Queratoplastia Penetrante/métodos , Masculino , Persona de Mediana Edad , Microscopía con Lámpara de Hendidura , Tomografía de Coherencia ÓpticaRESUMEN
Cytomegalovirus retinitis (CMVR) is a severe, vision-threatening disease that primarily affects immunosuppressed patients. CMVR is the most common ocular opportunistic infection in human immunodeficiency virus (HIV) infected patients and is the leading cause of blindness in this group; however, the incidence of CMVR in HIV patients has dramatically decreased with antiretroviral therapy. Other causes of immunosuppression, including organ transplantation, hematologic malignancies, and iatrogenic immunosuppression, can also lead to the development of CMVR. Herein, we describe the pathogenesis of CMVR and compare clinical features, epidemiology, and risk factors in HIV and non-HIV infected individuals with CMVR.