Microbial keratitis in Stevens-Johnson syndrome: Clinical and microbiological profile

To study the clinical and microbiological profile of microbial keratitis in Stevens-Johnson syndrome (SJS).

Case series.

Patients with SJS who developed microbial keratitis.

Medical records and microbiological data of patients with SJS who developed microbial keratitis from January 1991 to December 2012 were reviewed. We analysed the type of causative organisms and their antibiotic susceptibility along with the clinical pattern and responses to medications in this group of patients.

Clinical and microbiological profile of microbial keratitis.

We reviewed 65 eyes of 60 patients seen between January 1991 and December 2012. Positive microbiological culture results were obtained in 45 eyes (69.2%). Isolated bacterial infections were noted in 27 eyes (60%) while isolated fungal growth was seen in 1/45 eyes (2.2%). Polymicrobial infections were noted in 17/45 eyes (37.8%). The most common bacteria isolated were Staphylococcus species (35%). The median duration of SJS before presentation was 5 months (IQR, 2 months to 7 years) with 50% presenting within four months of the onset of SJS. Twenty-eight eyes (43%) needed treatment in addition to antibiotics for resolution of tarsorraphy, epilation, tissue adhesive application, and amniotic membrane grafting or punctal cautery. The average time for resolution was 25 days.

Microbial keratitis in SJS patients is different from patients without SJS in presentation and the response to medications. It requires a multi-disciplinary approach for healing.