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Streptococcal pharyngitis leading to corneal ulceration.
Ocular Immunology and Inflammation
|February 25, 2012
Summary
Bilevel positive airway pressure (BiPAP) use may lead to eye infections in children with streptococcal pharyngitis. This case report highlights the link between BiPAP, bacterial keratitis, and respiratory pathogens.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Pediatrics
Background:
- Bilateral bacterial keratitis is a serious ocular condition.
- Streptococcal pharyngitis is a common bacterial infection.
- Mechanical ventilation, including bilevel positive airway pressure (BiPAP), is used for respiratory support.
Observation:
- A 24-month-old child with cerebral palsy and a history of exposure keratopathy presented with bilateral bacterial keratitis.
- The child used BiPAP nightly for respiratory support.
- Ocular and oropharyngeal cultures identified Streptococcus pyogenes.
Findings:
- Pulsed-field gel electrophoresis confirmed the same strain of Streptococcus pyogenes in both ocular and pharyngeal cultures.
- This case demonstrates a concurrent association between streptococcal pharyngitis, bacterial keratitis, and BiPAP use.
Implications:
- Mechanical ventilation may increase the risk of ocular infections by facilitating the inoculation of respiratory or oropharyngeal pathogens.
- This is the first report to demonstrate this specific association, highlighting a potential complication of BiPAP therapy in susceptible pediatric patients.
- Ophthalmologists and pediatricians should consider this association in patients with similar clinical presentations.
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