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Polymicrobial Keratitis—Importance of Detecting and Treating More Than One Organism

Open Journal of Ophthalmology 2017年第1期7卷 64-72页

作者： Uma Sridhar Parul Jain Jyoti Batra neelam sapra Cornea Services ICARE Eye Hospital Noida India sapra Microbiology Centre Gurugram India

Corneal ulcers may become non-healing if inappropriately managed. Empirically giving broad spectrum antibiotics or prescription of a “cocktail” of topical antibacterial, antifungal and antiviral medication may only add to drug toxicity and drug resistance. We present a series of four cases of microbial keratitis which are complicated due to presence of more than one causative organism. Microbiological work-up revealed Proteus species and fungal hyphae in smears only in the first case, atypical Mycobacteria and Staphyloccocus species in the second case, Moraxella and Streptococcus viridans in the third case and Aspergillus flavus and Nocardia species in the fourth case. Authors would like to emphasize the need for laboratory support in the treatment of corneal ulcers and importance of proper management of this sight threatening disease.

关键词： Polymicrobial Keratitis Broad Spectrum Antibiotics Microbiological Work-Up

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Ocular Microsporidiosis—Our Experience in a Tertiary Care Centre in North India

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Open Journal of Ophthalmology 2015年第3期5卷 130-138页

作者： Uma Sridhar Amil Ausaf Ur Rahman Jyoti Batra neelam sapra Cornea Department ICARE Eye Hospital Noida India Training Centre ICARE Eye Hospital Noida India Microbiology Depatment Shroff Charity Eye Hospital New Delhi India

Microsporidia are obligate intracellular protozoal parasites. They are eukaryotic and spore forming. Increasing interest in this parasite as a pathogen in the ocular tissues in recent times is due to increasing awareness of microsporidia as an ocular pathogen and better methods of identification of the organism. It also can cause intestinal, sinus, pulmonary, muscular and renal diseases, in both immunocompetent and immunosuppressed patients. Ocular microsporidiosis can occur in isolation or as a part of systemic infections. In earlier published literature, ocular involvement in immunocompetent individuals was more in the form of stromal keratitis and immunocompromised individuals were seen to have keratoconjunctivitis. However, later studies show that this pattern has many variations. Occurrence in rainy season with exposure to muddy water and history of minor trauma is now a known factor. Identification by light microscopy from scrapings with KOH, Gram, Giemsa staining is possible. Growth of the organisms, however, is possible only by cell culture. Species identification is done by polymerase chain reaction and by electron microscopy. Immunofluorescent staining techniques are also available in advanced laboratories for species differentiation of microsporidia. Till date, treatment of ocular microsporidia has not been standardized and varies from simple debridement to use of various antibiotics, antiseptics antifungals and antiviral agents.

关键词： Microsporidia Keratoconjunctivitis Stromal Keratitis

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