Related Experiment Videos
Fulminant pseudomonal keratitis and scleritis in human immunodeficiency virus-infected patients
M Nanda1, S C Pflugfelder, S Holland
1Bascom Palmer Eye Institute, University of Miami School of Medicine, FL 33101.
Abstract:
Patients with human immunodeficiency virus infection are predisposed to fungal, parasitic, and viral infections. Bacterial infection can also be seen, although ocular bacterial infections have not been reported in patients with acquired immunodeficiency syndrome until recently. We present two cases of Pseudomonas corneoscleritis and one case of Pseudomonas keratitis in patients with human immunodeficiency virus infection that failed to respond to antibiotic treatment. Predisposing factors included extended-wear soft contact lens use in one patient and exposure secondary to Bell's palsy in another patient. All three patients had neutropenia that may have contributed to their poor response to treatment. Enucleation was required to treat two patients with overwhelming infection. Enucleation has been rarely required for treatment of corneoscleritis in immunocompetent patients treated at our institution. Pseudomonas keratitis in human immunodeficiency virus-infected patients represents a serious ocular infection requiring early diagnosis and aggressive treatment.
Insights
Bacterial ocular infections like Pseudomonas corneoscleritis and keratitis are emerging threats in patients with human immunodeficiency virus (HIV). These serious infections often resist standard antibiotic treatment, especially with neutropenia.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Immunology
Background:
- Patients with human immunodeficiency virus (HIV) are typically susceptible to opportunistic infections.
- Ocular bacterial infections are uncommon in acquired immunodeficiency syndrome (AIDS) patients, with limited prior reports.
- This study highlights a recent increase in severe bacterial ocular infections in HIV-positive individuals.
Observation:
- Two cases of Pseudomonas corneoscleritis and one case of Pseudomonas keratitis were observed in HIV-infected patients.
- These infections demonstrated resistance to conventional antibiotic therapies.
- Identified predisposing factors included extended-wear soft contact lens use and exposure secondary to Bell's palsy.
Findings:
- All three patients presented with neutropenia, a condition that may have impaired their response to treatment.
- Two patients required enucleation due to overwhelming ocular infection.
- Pseudomonas keratitis in HIV-infected patients is a severe condition with a poor prognosis.
Implications:
- Early diagnosis and aggressive treatment are crucial for managing Pseudomonas keratitis in HIV patients.
- The findings suggest a need for increased vigilance regarding bacterial ocular infections in immunocompromised populations.
- Corneoscleritis in HIV patients, particularly with Pseudomonas, may necessitate more aggressive interventions than in immunocompetent individuals.