Recalcitrant <b><i>Pseudomonas Aeruginosa</i></b> Keratitis with Hyphaema

Abstract

&lt;b&gt;&lt;i&gt;Purpose:&lt;/i&gt;&lt;/b&gt; To report a case of recalcitrant pseudomonas keratitis with a rare presentation of hyphaema. &lt;b&gt;&lt;i&gt;Observation:&lt;/i&gt;&lt;/b&gt; A 45-year-old female was noted to have contact lens-related pseudomonas keratitis with hyphaema. The organism was refractory to multiple antibiotics and only responded to Tazocin eye drops. &lt;b&gt;&lt;i&gt;Conclusion and Importance:&lt;/i&gt;&lt;/b&gt; Hyphaema is a rare presentation in bacterial keratitis and could represent infection with an especially virulent organism. Use of Aspirin could precipitate hyphaema in infective keratitis. Alternative antibiotic choices such as Tazocin, colistin, meropenem, and imipenem can be considered when standard therapy is ineffective for multidrug-resistant Pseudomonas keratitis.

Recalcitrant Multidrug-Resistant Pseudomonas Keratitis With Subsequent Triple Procedure

“…Recalcitrant keratitis caused by P. aeruginosa is a serious and potentially blinding condition. The aggressive nature of the organism coupled with its evolving multidrug resistance is an important cause of ocular morbidity (Chan et al 2021). This case report illustrates the importance of the initial treatment in bacterial keratitis.…”

Increased tolerance to commonly used antibiotics in aPseudomonas aeruginosa ex vivoporcine keratitis model

“…Studies on rabbits in vivo used various concentrations of gentamicin (1.6, 3, 5 &13 mg mL -1 ) to treat P. aeruginosa keratitis with mixed therapeutic outcome (Punitan et al, 2019, Rootman and Krajden, 1993, Fruchtpery et al, 1995, Silbiger and Stern, 1992, Gupta et al, 1995, Kowalski et al, 2013, Ahmad et al, 1977. One case study showed that the treatment with 14 mg mL -1 gentamicin failed even though the P. aeruginosa strains isolated from human cornea were identified as sensitive to this antibiotic (Chan et al, 2021). Some of the concentrations used in mentioned studies were cytotoxic because it was found that as little as of 3 mg mL -1 of this antibiotic is cytotoxic in human corneal epithelial cells in vitro (Tsai et al, 2010) and impairs the wound healing in rabbits in vivo (Stiebel-Kalish et al, 1998).…”