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Fulltext Cutaneous adverse drug reactions seen in a tertiary hospital in Johor, Malaysia

Ding WY, Lee CK, Choon SE

Int J Dermatol, 2010 Jul;49(7):834-41.
PMID: 20618508 DOI: 10.1111/j.1365-4632.2010.04481.x

BACKGROUND: Adverse drug reactions are most commonly cutaneous in nature. Patterns of cutaneous adverse drug reactions (ADRs) and their causative drugs vary among the different populations previously studied.
OBJECTIVE: Our aim is to determine the clinical pattern of drug eruptions and the common drugs implicated, particularly in severe cutaneous ADRs in our population.
MATERIALS AND METHODS: This study was done by analyzing the database established for all adverse cutaneous drug reactions seen from January 2001 until December 2008.
RESULTS: A total of 281 cutaneous ADRs were seen in 280 patients. The most common reaction pattern was maculopapular eruption (111 cases, 39.5%) followed by Stevens-Johnson Syndrome (SJS: 79 cases, 28.1%), drug reaction with eosinophilia and systemic symptoms (DRESS: 19 cases, 6.8%), toxic epidermal necrolysis (TEN: 16 cases, 5.7 %), urticaria/angioedema (15 cases, 5.3%) and fixed drug eruptions (15 cases, 5.3%). Antibiotics (38.8%) and anticonvulsants (23.8%) accounted for 62.6% of the 281 cutaneous ADRs seen. Allopurinol was implicated in 39 (13.9%), carbamazepine in 29 (10.3%), phenytoin in 27 (9.6%) and cotrimoxazole in 26 (9.3%) cases. Carbamazepine, allopurinol and cotrimoxazole were the three main causative drugs of SJS/TEN accounting for 24.0%, 18.8% and 12.5% respectively of the 96 cases seen whereas DRESS was mainly caused by allopurinol (10 cases, 52.6%) and phenytoin (3 cases, 15.8%).
DISCUSSION: The reaction patterns and drugs causing cutaneous ADRs in our population are similar to those seen in other countries although we have a much higher proportion of severe cutaneous ADRs probably due to referral bias, different prescribing habit and a higher prevalence of HLA-B*1502 and HLA-B*5801 which are genetic markers for carbamazepine-induced SJS/TEN and allopurinol-induced SJS/TEN/DRESS respectively.
CONCLUSION: The most common reaction pattern seen in our study population was maculopapular eruptions. Antibiotics, anticonvulsants and NSAIDs were the most frequently implicated drug groups. Carbamazepine and allopurinol were the two main causative drugs of severe ADRs in our population.

Matched MeSH terms: Anti-Bacterial Agents/adverse effects*
Fulltext Green synthesis and antibacterial effect of silver nanoparticles using Vitex negundo L

Zargar M, Hamid AA, Bakar FA, Shamsudin MN, Shameli K, Jahanshiri F, et al.

Molecules, 2011 Aug 08;16(8):6667-76.
PMID: 25134770 DOI: 10.3390/molecules16086667

Different biological methods are gaining recognition for the production of silver nanoparticles (Ag-NPs) due to their multiple applications. One of the most important applications of Ag-NPs is their use as an anti-bacterial agent. The use of plants in the synthesis of nanoparticles emerges as a cost effective and eco-friendly approach. In this study the biosynthesis of silver nanoparticles using Vitex negundo L. extract and its antimicrobial properties has been reported. The resulting silver particles are characterized using transmission electron microscopy (TEM), X-ray diffraction (XRD) and UV-Visible (UV-Vis) spectroscopic techniques. The TEM study showed the formation of silver nanoparticles in the 10-30 nm range and average 18.2 nm in size. The XRD study showed that the particles are crystalline in nature, with a face centered cubic (fcc) structure. The silver nanoparticles showed the antimicrobial activity against Gram positive and Gram negative bacteria. Vitex negundo L. was found to display strong potential for the synthesis of silver nanoparticles as antimicrobial agents by rapid reduction of silver ions (Ag+ to Ag0).

Matched MeSH terms: Anti-Bacterial Agents/pharmacology*
Subacute osteomyelitis masquerading as primary bone sarcoma: report of six cases

Dhanoa A, Singh VA

Surg Infect (Larchmt), 2010 Oct;11(5):475-8.
PMID: 20858161 DOI: 10.1089/sur.2009.011

We report a series of six immunocompetent patients who were believed initially to have primary bone sarcomas, but turned out to have subacute osteomyelitis.

Matched MeSH terms: Anti-Bacterial Agents/therapeutic use
Lactic acid as a potential decontaminant of selected foodborne pathogenic bacteria in shrimp (Penaeus merguiensis de Man)

Shirazinejad A, Ismail N, Bhat R

Foodborne Pathog Dis, 2010 Dec;7(12):1531-6.
PMID: 21034165 DOI: 10.1089/fpd.2010.0616

Fresh raw shrimps were dipped for 10, 20, and 30 min at room temperature (25°C ± 1°C) in lactic acid (LA; 1.5%, 3.0%, v/v) to evaluate their antipathogenic effects against Vibrio cholerae, Vibrio parahaemolyticus, Salmonella entreitidis, and Escherichia coli O157:H7 inoculated at a level of 10(5) CFU/g. Significant reductions in the population of all these pathogenic bacteria were recorded after dipping treatments, which were correlated to the corresponding LA concentrations and treatment time. With respect to the microbial quality, 3.0% LA treatment for 10 min was acceptable in reducing the pathogenic bacteria. Additionally, sensory evaluation results revealed a 10-min dip in 3.0% LA to be more acceptable organoleptically compared with 20 and 30 min of treatments. Results of the present study are envisaged to be useful for commercial applications for effective decontamination of shrimp.

Matched MeSH terms: Anti-Bacterial Agents/pharmacology*
Pediatric subperiosteal orbital abscess secondary to acute sinusitis: a 5-year review

Tan VES

Am J Otolaryngol, 2011 Jan-Feb;32(1):62-8.
PMID: 20031268 DOI: 10.1016/j.amjoto.2009.10.002

Objective: Subperiosteal orbital abscesses (SPOAs) secondary to acute sinusitis are rare occurrences in the pediatric age group, more so in the neonatal period. Here, a rare case of SPOA in a 38-day-old newborn later drained via endoscopic sinus surgery is included also. This review describes the demographic data, clinical history, treatment, microbiology results, complications, and outcome.
Methods: The admission records for all the patients who were admitted to the Pediatric Surgical Ward in Sarawak General Hospital, Kuching, Malaysia, between January 2004 and May 2009 were retrospectively reviewed. Records of patients who presented with preseptal cellulitis, orbital cellulitis, subperiosteal abscess (extraconal), orbital abscess (intraconal), and cavernous sinus thrombosis were closely studied. Ophthalmology consultations were obtained in all these cases. Ultimately, 3 patients having SPOA secondary to acute sinusitis were selected for this review.
Results: All patients were male with rapid onset of periorbital signs, absence of purulent rhinorrhea, and presence of significant thrombocytosis (exceeding 500 × 109/L). The 38-day-old newborn had mixed infection of methicillin-resistant coagulase-negative Staphylococcus bacteremia and local Acinetobacter eye infection with Staphylococcus aureus in the SPOA. All had medially located SPOA that was adequately drained via endoscopic sinus surgery, resulting in full recovery.
Conclusion: Newborns with preexisting risk factors and immature immunity are at risk of severe and rare infections. Contrast-enhanced paranasal sinus computed tomographic scan is mandatory and reliable to differentiate preseptal and postseptal orbital infection, as both conditions can present similarly and rapidly deteriorate. In the contrast-enhanced computed tomography–demonstrable SPOA, endoscopic sinus surgery drainage of the abscess proved to be safe and reliable as the main treatment modality. All patients recovered well without complications.

Matched MeSH terms: Anti-Bacterial Agents/therapeutic use
Antibiograms and molecular subtypes of methicillin-resistant Staphylococcus aureus in local teaching hospital, Malaysia

Thong KL, Junnie J, Liew FY, Yusof MY, Hanifah YA

J Microbiol Biotechnol, 2009 Oct;19(10):1265-70.
PMID: 19884790

The objectives of this study were to determine the antibiotypes, SCCmec subtypes, PVL carriage, and genetic diversity of MRSA strains from a tertiary hospital. Sixtysix MRSA strains were selected randomly (2003, 2004, and 2007) and tested for the Panton-Valentine leukocidin gene, mecA gene, and SCCmec type via a PCR. The antibiograms were determined using a standard disc diffusion method, and the genetic diversity of the isolates was determined by PFGE. Thirty-four antibiograms were obtained, with 55% of the 66 strains exhibiting resistance to more than 4 antimicrobials. All the isolates remained susceptible to vancomycin, and low resistance rates were noted for fusidic acid (11%), rifampicin (11%), and clindamycin acid (19%). The MRSA isolates that were multisensitive (n=12) were SCCmec type IV, whereas the rest (multiresistant) were SCCmec type III. Only two isolates (SCCmec type IV) tested positive for PVL, whereas all the isolates were mecA-positive. The PFGE was very discriminative and subtyped the 66 isolates into 55 pulsotypes (F=0.31-1.0). The multisensitive isolates were distinctly different from the multidrug-resistant MRSA. In conclusion, no vancomycin-resistant isolate was observed. The Malaysian MDR MRSA isolates were mostly SCCmec type III and negative for PVL. These strains were genetically distinct from the SCCmec type IV strains, which were sensitive to SXT, tetracycline, and erythromycin. Only two strains were SCCmec IV and PVL-positive. The infections in the hospital concerned were probably caused by multiple subtypes of MRSA.

Matched MeSH terms: Anti-Bacterial Agents/pharmacology*
Impact of a training intervention on use of antimicrobials in teaching hospitals

Akter SF, Heller RD, Smith AJ, Milly AF

J Infect Dev Ctries, 2009 Jul 01;3(6):447-51.
PMID: 19762958

BACKGROUND: Antimicrobials are often used inappropriately in paediatric wards of medical college hospitals in Bangladesh. Most of the antimicrobials are prescribed based on clinical grounds-signs and symptoms. This intervention study assessed the effectiveness of a training intervention on antimicrobials prescribing by physicians in paediatric wards of tertiary care level hospitals.
METHODOLOGY: This study was conducted at medical college hospitals in Bangladesh during the period from 1998 through 2000. The pre-intervention survey of antimicrobial use was conducted during 1998 in five hospitals. The post-intervention survey was conducted after the interactive training during the succeeding year in three of the original five hospitals, of which one was the intervention hospital and two control hospitals. A total of 3,466 admitted paediatric patients' treatment charts (2,171 in the pre-intervention and 1,295 in the post-intervention surveys) were reviewed.
RESULTS: The most commonly used antimicrobials were ampicillin, gentamicin, amoxicillin, cloxacillin and ceftriaxone. Appropriate antimicrobial therapy for the most common infectious diseases, pneumonia and diarrhoea, increased by 16.4% and 56.8% respectively in the intervention hospital compared with the two control hospitals and these improvements were significant (p = < 0.001 and p = 0.002, for pneumonia and diarrhoea respectively).
CONCLUSIONS: An interactive, focussed educational intervention, targeted at physicians, appears to have been effective in improving appropriate antimicrobial prescribing for the most common paediatric infectious diseases in a medical college hospital in Bangladesh.

Matched MeSH terms: Anti-Bacterial Agents/therapeutic use*
Fulltext First isolation of Burkholderia tropica from a neonatal patient successfully treated with imipenem

Deris ZZ, Van Rostenberghe H, Habsah H, Noraida R, Tan GC, Chan YY, et al.

Int J Infect Dis, 2010 Jan;14(1):e73-4.
PMID: 19482535 DOI: 10.1016/j.ijid.2009.03.005

We report the first case of a human Burkholderia tropica infection. The patient was a premature neonate who had necrotizing enterocolitis with bowel perforation requiring surgical intervention. The stoma care and difficulties in feeding were a chronic problem. At the age of almost 4 months he developed septicemia due to B. tropica. Three consecutive blood cultures grew this organism. The organism was cleared from the blood after a course of imipenem and resolution of post-operative ileus. Our case suggests that environmental and plant pathogens can cause human infection especially in those in an immunocompromised condition.

Matched MeSH terms: Anti-Bacterial Agents/therapeutic use*
Fulltext Local antibiotics are equivalent to intravenous antibiotics in the prevention of superficial wound infection in inguinal hernioplasty

Praveen S, Rohaizak M

Asian J Surg, 2009 Jan;32(1):59-63.
PMID: 19321405 DOI: 10.1016/S1015-9584(09)60011-7

Antibiotic prophylaxis for inguinal hernioplasty is still practiced in many hospitals to prevent consequences of infected mesh, mesh removal and hernia recurrence. The common route of administration is intravenous. However this method can be associated with systemic side effects. Alternatively, locally applied antibiotics have been used and proven to significantly reduce the infection rate after inguinal hernioplasty.

Matched MeSH terms: Anti-Bacterial Agents/administration & dosage*
Cases of melioidosis in a university teaching hospital in Malaysia

Raja NS

J Microbiol Immunol Infect, 2008 Apr;41(2):174-9.
PMID: 18473106

Melioidosis is an infectious disease caused by Burkholderia pseudomallei that is endemic in Southeast Asia and northern Australia and has also been reported from non-endemic areas of the world. Little is known about the antimicrobial susceptibility pattern and the demography of melioidosis patients in Malaysia.

Matched MeSH terms: Anti-Bacterial Agents/pharmacology*
Contact lens-related infectious keratitis in Malaysia

Reddy SC, Tajunisah I

Ann Ophthalmol (Skokie), 2008;40(1):39-44.
PMID: 18556981

Fifty-six contact lens-related corneal ulcers (central in 32; hypopyon in 24 and stromal abscess in 6) were studied. Culture was positive in 78.9%. Corneal ulcers healed with intense antibiotic therapy in nearly all patients. Increased awareness of lens care/disinfection and frequent replacement of storage cases and solution, and early detection of pathogens and intensive appropriate antibiotic therapy are key points in management.

Matched MeSH terms: Anti-Bacterial Agents/therapeutic use
In vitro activities of 28 antimicrobial agents against methicillin-resistant Staphylococcus aureus (MRSA) from a clinical setting in Malaysia

Neela V, Sasikumar M, Ghaznavi GR, Zamberi S, Mariana S

Southeast Asian J. Trop. Med. Public Health, 2008 Sep;39(5):885-92.
PMID: 19058585

Methicillin-resistant Staphylococcus aureus (MRSA), an established nosocomial and emerging community pathogen associated with many fatalities due to its hyper-virulence and multiple drug resistant properties, is on the continuous rise. To update the current status on the susceptibility of local MRSA isolates to various classes of antibiotics and to identify the most potent antibiotics, thirty-two clinical isolates comprised of hospital acquired (HA) and community acquired (CA) infections were investigated by disk diffusion test. Of the 32 MRSA isolates, 14 (43.75%) and 18 (56.25%) were community and hospital acquired MRSA, respectively. All isolates were multiple drug resistant to more than 3 classes of antibiotics despite the source or specimen from which it was isolated. The oxacillin MICs for all isolates ranged from 2 to > or = 256 microg/ml. Twenty-five of 26 erythromycin-resistant MRSA isolates exhibited an inducible MLS(B) resistance phenotype while one showed an MS phenotype. More than half the isolates (68.75%) were resistant to at least one of the six aminoglycosides tested, with netilmicin as the most susceptible. The most effective antistaphylococcal agents were linezolid, vancomycin, teicoplanin and quinupristin/dalfopristin exhibited 100% susceptibility. Since MRSA is under continuous pressure of acquiring multiple drug resistance, it is imperative to focus routine surveillance on HA and CA-MRSA strains to monitor and limit the spread of this organism.

Matched MeSH terms: Anti-Bacterial Agents/pharmacology*
Multisensitive community-acquired methicillin-resistant Staphylococcus aureus infections in Malaysia

Sam IC, Kahar-Bador M, Chan YF, Loong SK, Mohd Nor Ghazali F

Diagn Microbiol Infect Dis, 2008 Dec;62(4):437-9.
PMID: 18842374 DOI: 10.1016/j.diagmicrobio.2008.07.016

The 1st 9 clinical isolates of multisensitive community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) from Malaysia carry SCCmec type IV and predominantly cause skin and soft-tissue infections. Seven were classified as nosocomially acquired. There was considerable clonal diversity, with both pandemic and novel multilocus sequence types detected. CA-MRSA rates appear to be increasing in our hospital, warranting close surveillance.

Matched MeSH terms: Anti-Bacterial Agents/pharmacology
Antimicrobial activities of Psophocarpus tetragonolobus (L.) DC extracts

Sasidharan S, Zuraini Z, Yoga Latha L, Sangetha S, Suryani S

Foodborne Pathog Dis, 2008 Jun;5(3):303-9.
PMID: 18767977 DOI: 10.1089/fpd.2007.0078

Consecutive chloroform, ethanol, and ethyl acetate partitions of extracts from winged bean [Psophocarpus tetragonolobus (L.) DC] root, stem, leaf, and pod extracts were tested for their antimicrobial activity against 19 microbial species, including 11 bacterial pathogens, four yeasts, and four molds using the disk diffusion assay technique. The pod extract was found to be most effective against all of the tested organisms, followed by the stem, root, and leaf extracts, and the ethanol fraction showed the most significant (p < 0.05) antimicrobial activity against all of the tests among three soluble fractions of extract, followed by the ethyl acetate and chloroform fractions. The minimum inhibitory concentrations (MICs) of extracts determined by the broth dilution method ranged from 1.25 to 10.0 mg/mL. The MIC of ethanol fraction of pod extracts was the lowest by comparison with the other two extracts. The MIC for fungi was at or below 2.5 mg/mL and for bacteria was at or above 2.5 mg/mL.

Matched MeSH terms: Anti-Bacterial Agents/pharmacology*
Temporal bone actinomycosis: a histopathologic report

Sivarajasingam M, Rajan P

Otol Neurotol, 2007 Sep;28(6):869-70.
PMID: 17435522
Matched MeSH terms: Anti-Bacterial Agents/therapeutic use
Fulltext Modifying antibiotic prescribing: the effectiveness of academic detailing plus information leaflet in a Malaysian primary care setting

Teng CL, Achike FI, Phua KL, Nurjahan MI, Mastura I, Asiah HN, et al.

Med J Malaysia, 2006 Aug;61(3):323-31.
PMID: 17240584

We assessed the effectiveness of an educational intervention in reducing antibiotic prescribing in public primary care clinics in Malaysia. Twenty-nine medical officers in nine clinics received an educational intervention consisting of academic detailing from the resident Family Medicine Specialist, as well as an information leaflet. The antibiotic prescribing rates were assessed for six months - three months before and three months after the intervention. A total of 28,562 prescriptions were analyzed. Among participating doctors, general antibiotic prescribing rates for pre- and post-intervention phases were 14.3% and 11.0% (post-intervention vs pre-intervention RR 0.77, 95% CI 0.72 to 0.83). The URTI-specific antibiotic prescribing rates for pre- and post-intervention phases were 27.7% and 16.6%, respectively (post-intervention vs pre-intervention RR 0.60, 95% CI 0.54 to 0.66). No significant change in antibiotic prescribing rates was observed among primary care practitioners who did not participate in the study. This low cost educational intervention using both active and passive strategies focusing on URTI produced a statistically significant (and clinically important) reduction in antibiotic prescribing.
Study site: Klinik Kesihatan, Negeri Sembilan, Malaysia

Matched MeSH terms: Anti-Bacterial Agents/administration & dosage*
Antimicrobial susceptibility pattern of clinical isolates of Pseudomonas aeruginosa in a tertiary care hospital

Raja NS, Singh NN

J Microbiol Immunol Infect, 2007 Feb;40(1):45-9.
PMID: 17332906

BACKGROUND AND PURPOSE: Pseudomonas aeruginosa is an important cause of morbidity and mortality in hospitalized, critically ill patients and patients with underlying medical conditions such as cystic fibrosis, neutropenia, and iatrogenic immunosuppression. The prevalence of multiresistant P. aeruginosa isolates has been increasing. The aim of this study was to determine the antimicrobial susceptibility patterns in P. aeruginosa strains isolated at a university teaching hospital in Kuala Lumpur, Malaysia.
METHODS: The Laboratory Information System of the microbiology department was retrospectively reviewed to determine the susceptibility patterns of P. aeruginosa isolates to anti-pseudomonal antibiotics, from January to June 2005. Disk diffusion methods were employed and results were interpreted according to National Committee for Clinical Laboratory Standards guidelines.
RESULTS: 505 clinical isolates of P. aeruginosa were tested. Major sources of these isolates included respiratory tract, wound, urine and blood. The rates of antimicrobial resistance of isolates were 6.73% to amikacin, 12.9% to gentamicin, 10.1% to netilmicin, 10.9% to ceftazidime, 11.3% to ciprofloxacin, 9.9% to imipenem, 10.8% to piperacillin, 9.4% to piperacillin-tazobactam and 0% to polymyxin B. Of the 505 isolates, 29 (5.74%) were found to be multidrug-resistant; these were most commonly isolated from respiratory tract specimens of patients in surgical units, followed by respiratory tract specimens in patients in medical units.
CONCLUSIONS: The data in this study showed low rates of antibiotic resistance among P. aeruginosa isolates. Combinations of aminoglycosides plus beta-lactams or quinolones should be the appropriate choice for empirical therapy in P. aeruginosa infections. Active antibiotic susceptibility testing and surveillance should be continued in order to curtail the problem of antibiotic resistance.

Matched MeSH terms: Anti-Bacterial Agents/pharmacology*
A study on the knowledge, attitudes and practices of Southeast Asian dermatologists in the management of atopic dermatitis

Chan YC, Tay YK, Sugito TL, Boediardja SA, Chau DD, Nguyen KV, et al.

Ann Acad Med Singap, 2006 Nov;35(11):794-803.
PMID: 17160196

INTRODUCTION: This study evaluated the knowledge, attitudes and practices of Southeast Asian dermatologists in the management of atopic dermatitis (AD).
MATERIALS AND METHODS: A questionnaire survey of 255 dermatologists in Indonesia, Malaysia, the Philippines, Singapore, Thailand and Vietnam.
RESULTS: Familiarity with diagnostic criteria varied considerably. The usage of moisturisers by the respondents from Vietnam and Indonesia was significantly less frequent than the other countries. Most respondents (91% to 100%) used topical corticosteroids in children with mild-to-moderately severe dermatitis. Some respondents in the Philippines (17% to 19%) and Vietnam (11% to 25%) only used topical corticosteroids for severe disease. For infected eczema, most respondents would prescribe systemic antibiotics for mild-to-moderate infection. A minority in the Philippines (14%) and Vietnam (11%) did so only for severe infection. The top 4 systemic antibiotics prescribed most frequently were: erythromycin, cloxacillin, cephalosporin and amoxicillin/clavulanic acid. In Indonesia, a large proportion of the respondents (47%) prescribed amoxicillin most frequently. The majority of respondents (60% to 100%) prescribed both sedating and non-sedating oral antihistamines. Most respondents used oral corticosteroids to treat severe AD. Some in Malaysia, Singapore and Vietnam used cyclosporin (7% to 58%), azathioprine (5% to 31%) and methotrexate (5% to 14%). With the exception of those in Singapore, the majority of respondents (71% to 97%) did not use phototherapy.
CONCLUSION: Familiarity with diagnostic criteria, the early and judicious use of moisturisers and topical corticosteroids, as well as the treatment of Staphylococcus aureus superinfection with penicillinase-stable antibiotics should be emphasised in this region.

Matched MeSH terms: Anti-Bacterial Agents/therapeutic use*
Melioidosis: an uncommon cause of neck abscess

Zulkiflee AB, Prepageran N, Philip R

Am J Otolaryngol, 2008 Jan-Feb;29(1):72-4.
PMID: 18061838 DOI: 10.1016/j.amjoto.2007.02.004

INTRODUCTION: Melioidosis is a life-threatening disease caused by B. pseudomallei. It is endemic in Southeast Asia with a few reports from the Western world. It is transmitted via inhalation, ingestion or direct contact with an open wound. Clinically it may present with local or systemic symptoms. Mortality rate is very high in systemic disease; but local infection is usually mild, which causes delay in seeking medical attention.
CASE REPORT: We report a case of neck melioidosis presenting as a parapharyngeal abscess that was successfully managed with incision and drainage and intravenous ceftazidime and co-trimoxazole for 6 weeks followed by eradication therapy with oral co amoxiclav.
CONCLUSION: Neck melioidosis must be considered one of differential diagnoses for "cold abscesses" of the neck, especially in an endemic area, in Asian migrants, or in those with history of previous visit from the endemic regions.

Matched MeSH terms: Anti-Bacterial Agents/therapeutic use
Bilateral simultaneous infectious keratitis secondary to contact lens wear: an unusual case report with rare organisms

Ali NA, Reddy SC

Eye Contact Lens, 2007 Nov;33(6 Pt 1):338-40.
PMID: 17993833

PURPOSE: To report an unusual case of bilateral simultaneous hypopyon corneal ulcer in a contact lens wearer caused by polymicrobial infection with rare organisms.
METHODS: A case report of a 21-year-old soft contact lens wearer, who visited the emergency department with a 3-day history of pain, redness, decreased vision, photophobia, and tearing in both eyes. Examination showed a central corneal ulcer with hypopyon in both eyes. The cultures from corneal scrapings of both eyes, the contact lenses, and the contact lens solution showed heavy growth of Pseudomonas aeruginosa, Alkaligenes species, and Flavobacterium meningosepticum.
RESULTS: The corneal ulcers healed completely with aggressive antibiotic treatment for 4 weeks. The best-corrected visual acuity after 6 months of follow-up was 20/400 in the right eye and 20/60 in the left eye.
CONCLUSIONS: The possibility of infectious keratitis should be kept in mind for an acute red eye in contact lens wearers, and appropriate initial management is essential for a successful outcome. It is believed that this is the first report of Flavobacterium meningosepticum as a causative organism in contact lens-related keratitis.

Matched MeSH terms: Anti-Bacterial Agents/therapeutic use

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