반복각막진무름 후 혼합 세균각막염 1례

Abstract

Purpose: We report a case of keratitis of Stenotrophomonas maltophilia and Coagulase negative Staphylococcus in a recurrent corneal erosion patient. Methods: A 29-year-old female patient was referred to our clinic for an intractable corneal ulcer in her left eye. Results: Her best corrected visual acuity in her left eye was 10/400 and the cornea showed a 2×2 mm corneal infiltration at the 6 o`clock position along with endothelial plaque. Initially, 5% cefazolin, 1.4% tobramycin, 3.3% vancomycin, and 0.125% amphotericin were administered every 2 hours, and Natacyn(R) was administered every 4 hours, but corneal infiltration was still aggravated. After nine days of medical treatment, the advancement of the conjunctival flap was performed. The lesion had not improved, and corneal scrape and culture were repeated. Stenotrophomonas maltophilia and Coagulase negative Staphylococcus were identified. Treatment with clindamycin and Cravit(R), to which isolated organisms are susceptible, was started, and the lesion improved. During the treatment, her right eye showed a painful epithelial defect in the morning, and a few days later recurrent corneal epithelial bullae developed in her left eye. She was diagnosed with recurrent corneal erosion in both eyes. The infection lesion improved by using 2% clindamycin and Cravit(R), but the corneal bullae were not controlled, and therefore all eyedrops gradually tapered. After the cessation of eyedrops, corneal epithelial bullae disappeared. When she visited our clinic 12 days after discharge, her vision was 20/30 and her corneal lesion had improved completely.