title: Bacillus cereus infection after Descemet stripping endothelial keratoplasty.
abstract: OBJECTIVE
  To report the first case of Bacillus cereus keratitis leading to panophthalmitis in a patient operated for combined Descemet stripping endothelial keratoplasty (DSEK) and phacoemulsification with intraocular lens implantation.
  
  
  METHODS
  A 40-year-old woman with corneal decompensation underwent DSEK with phacoemulsification and posterior chamber intraocular lens implantation and developed corneal infiltrate in the host cornea progressing to ring corneal abscess and panophthalmitis within 72 hours of surgery.
  
  
  RESULTS
  The microbiological examination of the patient's corneal scraping revealed Gram-positive rods on the smear and the culture grew B. cereus. The source of the organism was found to be in the conjunctival sac of the patient because the conjunctival swab culture from the other eye revealed B. cereus. Despite vigorous topical and systemic antibacterial therapy, and immediate therapeutic penetrating keratoplasty, the infection progressed to panophthalmitis and required evisceration on the fifth day.
  
  
  CONCLUSIONS
  Bacillus cereus is a rare potential cause of postoperative infective keratitis after DSEK. The fulminant nature of the infection and its spread resulting in the loss of vision poses diagnostic and therapeutic challenges to corneal surgeons.
authors.affiliation: Cornea Department, Disha Eye Hospitals and Research Centre, Barrackpore, Kolkata, India. basak_sk@hotmail.com
authors.forename: Samar K
authors.initials: SK
authors.lastname: Basak
authors.forename: Sheetal S
authors.initials: SS
authors.lastname: Deolekar
authors.forename: Ayan
authors.initials: A
authors.lastname: Mohanta
authors.forename: Sanjib
authors.initials: S
authors.lastname: Banerjee
authors.forename: Suman
authors.initials: S
authors.lastname: Saha
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001409:Bacillus cereus / Q000302:isolation & purification*; D003320:Corneal Ulcer / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D057111:Descemet Stripping Endothelial Keratoplasty; D017234:Eye Evisceration; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D019654:Lens Implantation, Intraocular; D010202:Panophthalmitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D018918:Phacoemulsification; D011183:Postoperative Complications; D014792:Visual Acuity
chemical_list: D000900:Anti-Bacterial Agents