Unilateral Mycobacterium Chelonae Keratitis after Laser in situ Keratomileusis
Schöpfer D., Bühren J., Muller L., Kohnen T.
Department of Ophthalmology, Johann Wolfgang Goethe-Universität, Frankfurt/Main,
Purpose: Infectious keratitis is a rare complication after refractive corneal surgery. Apart from common pathogenes like Staphylococcus aureus and Staphylococcus epidermidis atypical mycobacteria should be considered.
Method: Case report: A 52 year-old female presented with a corneal infiltrate in her left eye one week after bilateral laser in situ keratomileusis done elsewhere. Initially, epithelial ingrowth or infectious keratitis were suspected. After detection of Mycobacterium chelonae DNA by PCR, the patient was treated topically with Amikacine and Levofloxacine eyedrops; systemical chemotherapy was performed with Clarithromycin 2x500mg/d.
Results: Despite of appropriate therapy, flap amputation was necessary due to progredient flap melting and hypopyon. The other eye showed a regular postoperative course with good uncorrected visual acuity.
Conclusions: In case of infiltrates after corneal refractive surgery atypical pathogenes like Mycobacterium chelonae should be considered.
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