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Perineural infiltrates in Pseudomonas keratitis
Scott J Robbie1, Felipe A Vega, Naing L Tint
1From Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom.
Journal of Cataract and Refractive Surgery
|October 29, 2013
Summary
Perineural infiltrates in contact lens-related keratitis can be caused by Pseudomonas aeruginosa, not just Acanthamoeba. Prompt treatment with levofloxacin led to rapid recovery in these cases.
Area of Science:
- Ophthalmology
- Microbiology
- Infectious Diseases
Background:
- Contact lens wear is a significant risk factor for microbial keratitis.
- Perineural infiltrates on presentation can suggest specific etiologies, historically Acanthamoeba.
- Pseudomonas aeruginosa is a common and potentially severe cause of bacterial keratitis.
Observation:
- Two cases of contact lens-related microbial keratitis presented with perineural infiltrates.
- Confocal microscopy was negative for Acanthamoeba cysts in both patients.
- Corneal scrapings confirmed Pseudomonas aeruginosa infection via microscopy and bacterial culture.
Findings:
- Perineural infiltrates are not exclusive to Acanthamoeba infections and can be present in Pseudomonas aeruginosa keratitis.
- Early and accurate diagnosis of bacterial keratitis is crucial for appropriate management.
Implications:
- Clinicians should consider Pseudomonas aeruginosa as a potential cause of keratitis with perineural infiltrates.
- This finding broadens the differential diagnosis for perineural infiltrates in microbial keratitis.
- Prompt initiation of targeted antibiotic therapy, such as topical levofloxacin, can lead to favorable outcomes.
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