Rapid diagnosis and treatment of mycobacterial keratitis after laser in situ keratomileusis.
We report the results of laser in situ keratomileusis (LASIK) in a 51-year-old woman with subsequent mycobacterial keratitis diagnosed by staining with acid-fast and fluorochrome methods, a technique known to have good sensitivity and specificity for mycobacteria. A rapid diagnosis was made without waiting for cultures, and treatment was instituted, including tapering of topical steroids and appropriate antibiotic therapy. The result was preservation of the LASIK flap and a favorable visual outcome at 6 months.
Daines
Bradley S
BS
Magill Research Center for Vision Correction, Department of Ophthalmology, Storm Eye Institute, 167 Ashley Avenue, Charleston, SC 29425, USA.
Vroman
David T
DT
Sandoval
Helga P
HP
Steed
Lisa L
LL
Solomon
Kerry D
KD
D000583:Amikacin / Q000008:administration & dosage; D001431:Bacteriological Techniques; D002939:Ciprofloxacin / Q000008:administration & dosage; D017291:Clarithromycin / Q000008:administration & dosage; D003320:Corneal Ulcer / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D003941:Diagnostic Techniques, Ophthalmological; D004359:Drug Therapy, Combination / Q000008:administration & dosage; D015818:Eye Infections, Bacterial / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D005260:Female; D006801:Humans; D007202:Indicators and Reagents; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D016926:Mycobacterium chelonae / Q000302:isolation & purification*; D009216:Myopia / Q000601:surgery; D011183:Postoperative Complications; D013194:Staining and Labeling / Q000379:methods; D014031:Tobramycin / Q000008:administration & dosage
D007202:Indicators and Reagents; D002939:Ciprofloxacin; D000583:Amikacin; D017291:Clarithromycin; D014031:Tobramycin