title: Delayed-onset Actinomyces keratitis after laser in situ keratomileusis.
abstract: OBJECTIVE
  To present a case of delayed-onset unilateral keratitis caused by Actinomyces israelii after laser in situ keratomileusis (LASIK).
  
  
  METHODS
  A 28-year-old woman was referred to our clinic because of foreign-body sensation and mild blurred vision in her left eye. She had bilateral simultaneous LASIK approximately 5 months ago. On slit-lamp examination, there was an area of infiltration in the corneal interface. The LASIK flap was elevated, and the involved area was scraped and irrigated with antibiotic solutions.
  
  
  RESULTS
  Culture and smear showed A. israelii as a causative agent, and the keratitis was successfully treated by antibiotics chosen according to antibiotic sensitivity test.
  
  
  CONCLUSIONS
  Actinomyces israelii must be considered in differential diagnosis of delayed-onset microbial keratitis after LASIK. Flap elevation, scraping, and irrigating the involved area can be helpful to obtain specimens for culture and smear and to control infection.
authors.affiliation: Ophthalmic Research Center, Labbafinejad Medical Center, Shaheed Beheshti Medical University, Tehran, Iran. karimianf@yahoo.com
authors.forename: Farid
authors.initials: F
authors.lastname: Karimian
authors.forename: Sepehr
authors.initials: S
authors.lastname: Feizi
authors.forename: Roshanak
authors.initials: R
authors.lastname: Nazari
authors.forename: Parviz
authors.initials: P
authors.lastname: Zarin-Bakhsh
mesh_terms: D000190:Actinomyces / Q000302:isolation & purification; D000196:Actinomycosis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002437:Cefazolin / Q000627:therapeutic use; D019781:Corneal Topography; D003320:Corneal Ulcer / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D004359:Drug Therapy, Combination; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D005469:Fluorometholone / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D008826:Microbial Sensitivity Tests; D011183:Postoperative Complications; D013524:Surgical Flaps; D013752:Tetracycline / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D005938:Glucocorticoids; D013752:Tetracycline; D002437:Cefazolin; D005469:Fluorometholone