Mycobacterium chelonae keratitis: resolution after debridement and presoaked collagen shields.
We report a case of Mycobacterium chelonae keratitis following corneal injury by a foreign body. Diagnosis was made by Ziehl-Neelsen staining and Löwenstein-Jensen culture of corneal scrapings. On the basis of the in vitro susceptibility testing, the patient was treated with topical fortified amikacin. Given the lack of response to this therapy, we decided to carry out a debridement of the infiltrative areas to eliminate infected tissue, and to use an amikacin-soaked collagen shield supplemented every 4 h with topical fortified amikacin to promote healing of the debrided area and to potentiate the effects of the antibiotic therapy. After this treatment, clinical resolution was observed and a further acid-fast stain and culture for mycobacterium were negative. Debridement of the infiltrative areas could be used in cases of mycobacterium keratitis when early diagnosis is made and before the corneal infection has become widespread.
Lois
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N
Department of Ophthalmology, Hospital General de Galicia-Clínico Universitario, Universidad de Santiago de Compostela, Spain.
Perez del Molino
M L
ML
D000328:Adult; D000583:Amikacin / Q000008:administration & dosage*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D003094:Collagen; D003131:Combined Modality Therapy; D003315:Cornea / Q000382:microbiology / Q000473:pathology; D065306:Corneal Injuries; D003646:Debridement / Q000379:methods*; D016503:Drug Delivery Systems; D005129:Eye Foreign Bodies / Q000382:microbiology; D015818:Eye Infections, Bacterial / Q000382:microbiology / Q000473:pathology / Q000628:therapy*; D005131:Eye Injuries / Q000382:microbiology; D006801:Humans; D007634:Keratitis / Q000382:microbiology / Q000473:pathology / Q000628:therapy*; D008297:Male; D009165:Mycobacterium Infections, Nontuberculous / Q000382:microbiology / Q000473:pathology / Q000628:therapy*; D016926:Mycobacterium chelonae / Q000302:isolation & purification*; D014949:Wounds, Nonpenetrating / Q000382:microbiology
D000900:Anti-Bacterial Agents; D000583:Amikacin; D003094:Collagen