title: Pneumococcal keratitis at the flap interface after laser in situ keratomileusis.
abstract: A 28-year-old woman had uneventful laser in situ keratomileusis in the right eye. Six days postoperatively, she reported ocular pain and a large corneal stromal infiltrate was observed at the flap interface. A second surgery including lifting and excising the flap and scraping the stromal bed was performed. Topical antibiotics were prescribed. A bacterial culture revealed Streptococcus pneumoniae. The keratitis responded well to topical vancomycin. Twelve days after the second surgery, the stromal infiltrate had regressed, the hypopyon had resolved, and visual acuity was hand movements at 0.5 m.
authors.affiliation: Cornea and Refractive Surgery Services, Asociación Para Evitar la Ceguera en México, Hospital Luis Sánchez Bulnes, Universidad Nacional Autónoma de México, Mexico City, Mexico. mramirezf@medicasur.org.mx
authors.forename: Manuel
authors.initials: M
authors.lastname: Ramírez
authors.forename: Everardo
authors.initials: E
authors.lastname: Hernández-Quintela
authors.forename: Francisco
authors.initials: F
authors.lastname: Beltrán
authors.forename: Ramón
authors.initials: R
authors.lastname: Naranjo-Tackman
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003319:Corneal Stroma / Q000382:microbiology*; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D007634:Keratitis / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D011008:Pneumococcal Infections / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D012086:Reoperation; D013296:Streptococcus pneumoniae / Q000302:isolation & purification*; D013524:Surgical Flaps / Q000382:microbiology*; D014640:Vancomycin / Q000627:therapeutic use; D014792:Visual Acuity
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin