Nocardia keratitis after traumatic detachment of a laser in situ keratomileusis flap.
OBJECTIVE
Nocardia are gram-positive bacteria existing ubiquitously in the environment; they can cause keratitis. Nocardia asteroides keratitis occurred in the interface between the stromal bed and flap after traumatic detachment of the flap 4 months after an initially uncomplicated laser in situ keratomileusis (LASIK) procedure.


METHODS
Nocardia asteroides keratitis was confirmed by culture. Therapy included topical and oral trimethoprim-sulfamethoxazole.


RESULTS
Thirteen months after the trauma, the patient's spectacle-corrected visual acuity was 20/20 with a manifest refraction of -2.25 -1.00 x 30 degrees.


CONCLUSIONS
The immediate steps of management consisting of surgically lifting the corneal flap, rapid microbial identification, and proper treatment with specific antibiotics resulted in the successful treatment of Nocardia asteroides keratitis in a traumatized eye after LASIK.
Kim
E K
EK
Institute of Vision Research and Department of Ophthalmology, Brain Korea 21, Yonsei University College of Medicine, Seoul.
Lee
D H
DH
Lee
K
K
Lim
S J
SJ
Yoon
I S
IS
Lee
Y G
YG
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D003315:Cornea / Q000382:microbiology / Q000601:surgery; D065306:Corneal Injuries; D004359:Drug Therapy, Combination; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000382:microbiology; D005131:Eye Injuries / Q000382:microbiology*; D006801:Humans; D007634:Keratitis / Q000188:drug therapy / Q000382:microbiology*; D020731:Keratomileusis, Laser In Situ; D008297:Male; D009617:Nocardia Infections / Q000188:drug therapy / Q000382:microbiology*; D009616:Nocardia asteroides / Q000302:isolation & purification; D009883:Ophthalmic Solutions; D013420:Sulfamethoxazole / Q000008:administration & dosage; D013524:Surgical Flaps / Q000382:microbiology*; D014295:Trimethoprim / Q000008:administration & dosage; D014792:Visual Acuity; D014949:Wounds, Nonpenetrating / Q000150:complications
D000900:Anti-Bacterial Agents; D009883:Ophthalmic Solutions; D014295:Trimethoprim; D013420:Sulfamethoxazole