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Query: UMLS:C0022568 (keratitis)
 5,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We cared for two patients with longstanding vernal keratoconjunctivitis who had bacterial corneal ulcers in each eye. Both patients were young, black, and had histories of atopy. The patients came for treatment with acute symptoms of pain, redness, and reduced vision in the affected eye. On examination in each case we found an epithelial defect associated with dense stromal infiltration, a calcific plaque in the bed of the ulcer, and a severe anterior chamber reaction, including a hypopyon in two cases. Cultures of corneal scrapings from all four eyes were positive for Staphylococcus aureus, and three of the four infections were polymicrobial. All four eyes responded rapidly to intensive topical antibiotic therapy, debridement of the calcific plaque, and subsequent treatment with topical corticosteroids and/or cromolyn sodium. Bacterial keratitis can occur in patients with vernal keratoconjunctivitis, especially those with vernal corneal ulcers. The abnormalities of ocular immune mechanisms found in patients with vernal keratoconjunctivitis may predispose them to bacterial keratitis.
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PMID:Bacterial keratitis associated with vernal keratoconjunctivitis. 142 58

Bacterial keratitis is an opportunistic infection of the avascular corneal stroma, initiated by a breakdown of the epithelial barrier. Corneal abrasion with infected material, extended-wear contact lenses, eyelid disease, and disorders of the ocular surface are predominant contributing factors. Acute bacterial conjunctivitis occurs when sufficient bacteria are introduced into the fornices to overwhelm normal bacteriostatic and flushing mechanisms. Chronic conjunctivitis is associated with a constant adnexal source of bacteria and resolves when the source is successfully treated. Rapid diagnosis and treatment of bacterial keratitis are essential to limit stromal scarring and minimize visual loss.
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PMID:A review of bacterial keratitis and bacterial conjunctivitis. 192 69

We used a rabbit model to investigate the pathogenesis of soft contact lens-induced bacterial keratitis. Rabbit eyes underwent complete tarsorrhaphy for 7 days either with (group A, n = 14) or without (group B, n = 13) new sterile soft contact lenses. On day 7, an increase in mean corneal thickness (20.3% in group A and 17.2% in group B) was detected. New or rabbit-worn soft contact lenses were then inoculated with 10(7) colony-forming units of Pseudomonas aeruginosa or by 0.1 mL of P aeruginosa suspension. On day 9, conjunctival cultures of all eyes yielded P aeruginosa. Corneal infection developed in 11 of 14 eyes wearing new or worn, contaminated soft contact lenses. Bacterial keratitis did not develop in any of the 13 eyes inoculated with P aeruginosa suspension. Light and electron microscopy of infected eyes showed abundant polymorphonuclear neutrophils destroying the epithelium, basement membrane, and stroma. Few bacteria could be detected and only in the deep stroma. Since bacterial suspension alone caused no inflammation, soft contact lens-wear appears crucial to corneal infection in this model.
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PMID:Experimental Pseudomonas aeruginosa keratitis from extended wear of soft contact lenses. 212 Nov 23

New or used extended-wear soft contact lenses, preincubated in suspensions of Pseudomonas aeruginosa, were placed on the corneas of rabbits. The lids were then sutured shut for either 1 or 2 weeks. Bacterial keratitis occurred in 9 of 9 eyes fitted with the used contaminated lenses but in none of 12 eyes fitted with new contaminated or new noncontaminated lenses. Similar experiments were carried out with other lenses specifically designed to fit the cornea of rabbits. Some of these lenses were preworn by rabbits for 1 week (used), whereas others were new. A significantly greater incidence of bacterial keratitis was found in eyes that had undergone lid closure after the placement of used contaminated lenses (4 of 5) than in closed eyes with new contaminated lenses (1 of 8) and in open eyes with used contaminated lenses (0 of 13). These findings suggest that extended eyelid closure is a risk factor in the experimental model and may be a factor in clinical Pseudomonas keratitis associated with the wearing of extended-wear soft contact lenses.
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PMID:Effect of lid closure on contact lens-associated Pseudomonas keratitis. 251 Jul 7

Bacterial keratitis continues to be a serious problem in developing countries. The authors studied 881 patients who had undergone penetrating keratoplasty (total of 947 procedures) from January 1983 to March 1986 at the King Khaled Eye Specialist Hospital, Riyadh, Saudia Arabia. All patients were followed for at least 6 months. Clinical evidence of bacterial keratitis developed in 113 (11.9%) eyes with penetrating keratoplasties in 108 patients. The causative organisms among those patients included: Streptococcus pneumoniae, 29 (26%); Staphylococcus epidermidis, 24 (21%); Pseudomonas aeruginosa, 13 (12%); Staphylococcus aureus, 5 (4%); Hemophilus influenzae, 5 (4%); Moraxella spp, 5 (4%); alpha-hemolytic streptococcus, 5 (4%); and other bacteria, 27 (25%). In addition, postoperative epithelial defects that required hospital admission for treatment developed in 21 (2.2%) patients. Herpetic keratitis developed in three (0.3%) patients and fungal keratitis developed in 1 (0.1%). Statistically significant predisposing risk factors included: trichiasis (P less than 0.0001), epithelial defects (P less than 0.0001), soft contact lens wear (P less than 0.0001), and eroding sutures (P less than 0.0001). The authors believe that the incidence of postoperative bacterial keratitis can be minimized or avoided by appropriate selection of patients for penetrating keratoplasties as well as good preoperative and postoperative management of associated ocular conditions.
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PMID:Bacterial keratitis after penetrating keratoplasty. 306 24

Bacterial keratitis is reported more frequently in the literature with the use of extended-wear contact lenses. This report describes a case of bilateral simultaneous pseudomonas keratitis in an elderly patient wearing extended-wear contact lenses for correction of myopia. The lenses were not properly disinfected prior to the development of the corneal ulcers. When bacterial keratitis is suspected with the use of extended-wear contact lenses, prompt diagnosis and treatment are necessary. Appropriate microbiologic testing of the contact lenses, lens cases, and lens solutions should also be undertaken.
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PMID:Bilateral simultaneous Pseudomonas keratitis with myopic extended-wear contact lenses. 347 7

A 34-year-old man who had excimer laser photorefractive keratectomy (PRK) for myopia developed bacterial keratitis from Pseudomonas aeruginosa. He was treated with intensive topical and systemic antimicrobial agents. The eye recovered an uncorrected visual acuity of 20/30. Bacterial keratitis can occur in young, healthy patients after PRK, especially when a bandage soft contact lens is used without appropriate prophylactic measures.
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PMID:Bacterial keratitis after photoreactive keratectomy in a young, healthy man. 929 85

A 50-year-old man had uneventful bilateral laser in situ keratomileusis (LASIK) for moderate myopia (-4.50 diopters sphere, both eyes). Twelve days postoperatively, he developed unilateral bacterial keratitis. Cultures revealed methicillin-resistant Staphylococcus aureus. The antibiotic regimen was adjusted, and he regained an uncorrected visual acuity of 20/40 and a best spectacle-corrected visual acuity (BSCVA) of 20/15. Bacterial keratitis after LASIK is a rare occurrence. Aggressive use of cultures and fortified antibiotics can prevent significant loss of BSCVA, even when a resistant organism is the cause.
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PMID:Methicillin-resistant Staphylococcus aureus keratitis after laser in situ keratomileusis. 1125 63

Bacterial keratitis is a sight-threatening corneal disease that is most commonly associated with the extended wear of soft contact lenses. Over the past decade, we have investigated the pathogenesis of infectious keratitis involving the opportunistic pathogen Pseudomonas aeruginosa. Our research has focused on understanding the respective roles of bacteria and host in the establishment of this infection. Here, we provide a current perspective on P. aeruginosa keratitis, reviewing some of the research developments that have helped shape our views on the mechanisms by which pathogen and host response cause corneal disease. P. aeruginosa may provide a model for the pathogenesis of bacterial keratitis and help further elucidate the complex array of host factors that normally protect the cornea from infectious agents.
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PMID:The pathogenesis of bacterial keratitis: studies with Pseudomonas aeruginosa. 1236 47

Contact lens-related infectious keratitis is a potentially sight-threatening complication. Bacterial keratitis, mostly due to Gram-negative bacteria, is associated with poor lens hygiene, overnight wear, and contaminated lens care solutions. Contamination of the lens storage case may cause fungal keratitis. Acanthamoeba infection is related to the use of tap water or swimming while wearing soft lenses. Viruses are of less concern among contact lens wearers. Possible transmission of Creutzfeldt-Jakob disease by multi-patient trial lenses must be taken in account. To minimize these risk factors, regulations are applied at various levels: CE marking of contact lenses and care products as they are medical devices; contact lens fitting only by health care professionals; distribution of contact lenses by opticians and lens care solutions by opticians and pharmacists; hygienic management of trial lenses following official recommendations. Contact lens-related keratitis must be reported to health care Authorities.
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PMID:[Rules and regulations concerning contact lens-related infection]. 1517 56


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