title: Streptococcal pharyngitis leading to corneal ulceration.
abstract: OBJECTIVE
  To report a patient with a history of exposure keratopathy who presented with bilateral bacterial keratitis associated with streptococcal pharyngitis and use of bilevel positive airway pressure (BiPAP).
  
  
  METHODS
  Case report.
  
  
  METHODS
  Pulsed-field gel electrophoresis of patient isolates from ocular and pharyngeal cultures.
  
  
  RESULTS
  Ocular and oropharyngeal cultures from a 24-month-old child with a history of cerebral palsy on BiPAP at night revealed the same strain of Streptococcus pyogenes.
  
  
  CONCLUSIONS
  Use of mechanical ventilation, such as BiPAP, may precipitate inoculation of eye with respiratory or oropharyngeal pathogens. To the authors' knowledge this is the first report demonstrating the association between concurrent streptococcal pharygitis, keratitis, and use of BiPAP.
authors.forename: Tarra W
authors.initials: TW
authors.lastname: Millender
authors.forename: L Barth
authors.initials: LB
authors.lastname: Reller
authors.forename: Landon C
authors.initials: LC
authors.lastname: Meekins
authors.forename: Natalie A
authors.initials: NA
authors.lastname: Afshari
mesh_terms: D002675:Child, Preschool; D003320:Corneal Ulcer / Q000382:microbiology*; D016521:Electrophoresis, Gel, Pulsed-Field; D006801:Humans; D008297:Male; D010612:Pharyngitis / Q000382:microbiology*; D011175:Positive-Pressure Respiration / Q000009:adverse effects / Q000379:methods; D013290:Streptococcal Infections / Q000150:complications*; D013297:Streptococcus pyogenes / Q000302:isolation & purification