ABSTRACT
Streptococcus pyogenes (group A beta-hemolytic Streptococcus, GABHS) causes a range of human infections, including necrotizing fasciitis and toxic shock syndrome, because it produces exotoxins that damage host cells, facilitate immune evasion, and serve as T cell superantigens. GABHS conjunctivitis is rare. We report a case of membranous conjunctivitis in a 3-year-old child who was treated with a combination of targeted bactericidal antimicrobials, toxin-synthesis inhibition, and amniotic membrane transplantation.
Subject(s)
Amnion , Anti-Bacterial Agents , Keratoconjunctivitis , Streptococcal Infections , Streptococcus pyogenes , Humans , Amnion/transplantation , Streptococcus pyogenes/isolation & purification , Streptococcal Infections/microbiology , Streptococcal Infections/diagnosis , Streptococcal Infections/drug therapy , Child, Preschool , Anti-Bacterial Agents/therapeutic use , Keratoconjunctivitis/microbiology , Keratoconjunctivitis/drug therapy , Keratoconjunctivitis/diagnosis , Keratoconjunctivitis/surgery , Combined Modality Therapy , Eye Infections, Bacterial/microbiology , Eye Infections, Bacterial/drug therapy , Eye Infections, Bacterial/diagnosis , Male , Drug Therapy, Combination , Conjunctivitis, Bacterial/microbiology , Conjunctivitis, Bacterial/drug therapy , Conjunctivitis, Bacterial/diagnosis , FemaleABSTRACT
Purpose: We present a case of eyelid reconstruction using ENDURAGen, a porcine-derived acellular collagen graft, complicated by dissolution of the graft in a patient recently diagnosed with α-Gal disease. Observations: A 33-year-old female status post enucleation of the left eye at age 7 struggling with malposition of her prosthesis due to lower lid retraction and laxity underwent eyelid reconstruction with ENDURAGen. She did well post-operatively for 9 months, but then began having issues with prosthesis dislodgement and rotation. Around that time, the patient was diagnosed with α-Gal disease. Repeat eyelid reconstruction was performed, this time with an ear cartilage graft, and dissolution of the original ENDURAGen graft was confirmed. Conclusions and importance: This case highlights the need for evaluation of the durability of ENDURAGen in patients with α-Gal and for caution in choosing porcine or bovine-derived implants for tissue reconstruction in this population.
