title: Clinical presentation of microbial keratitis with daily wear frequent-replacement hydrogel lenses: a case series.
abstract: Microbial keratitis (MK) is a serious complication associated with contact lens wear. In this case series we report three clinical presentations of MK associated with daily-wear monthly-replacement soft contact lenses. All of these patients were using vifilcon A (55% water content, ionic, U.S. Food and Drug Administration [FDA] group IV) monthly-replacement soft contact lenses. A gram-stained smear of the corneal scrapings of two patients showed numerous gram-negative cocci bacilli, and tissue cultures showed significant growth of Pseudomonas aeruginosa. In the third patient, the corneal scrapings showed numerous gram-negative bacilli, along with gram-positive cocci, and tissue culture showed significant growth of Aeromonas species and alpha-hemolytic streptococci. All these cases were resolved by medical therapy. This case series highlights the importance of patient symptoms, clinical features, and microbiologic work-up in making a differentiation between MK and sterile contact lens-induced peripheral ulcer (CLPU). A high index of suspicion and close follow-up care will avoid misdiagnosis and reduce complications.
authors.affiliation: Bausch & Lomb Contact Lens Center, L.V. Prasad Eye Institute, Hyderabad, India. konda@lvpeye.stph.net
authors.forename: Nagaraju
authors.initials: N
authors.lastname: Venkata
authors.forename: Savitri
authors.initials: S
authors.lastname: Sharma
authors.forename: Rashmi
authors.initials: R
authors.lastname: Gora
authors.forename: Rajni
authors.initials: R
authors.lastname: Chhabra
authors.forename: Murali K
authors.initials: MK
authors.lastname: Aasuri
mesh_terms: D000293:Adolescent; D000328:Adult; D000333:Aeromonas / Q000302:isolation & purification*; D000890:Anti-Infective Agents / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000627:therapeutic use; D003263:Contact Lenses, Hydrophilic / Q000009:adverse effects*; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D006801:Humans; D007634:Keratitis / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification*
chemical_list: D000890:Anti-Infective Agents; D002939:Ciprofloxacin