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Clinical features of Streptococcus pyogenes keratitis: Case series
Sohani Amarasekera1, Asad F Durrani2, Samuel Faith1
1University of Pittsburgh Medical Centre, Pittsburgh, PA, USA.
Summary
Streptococcus pyogenes keratitis is uncommon but can cause severe eye damage. Early treatment is crucial, as most strains remain susceptible to common antibiotics like cefazolin and fluoroquinolones.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Microbiology
Background:
- Streptococcus pyogenes is an uncommon cause of keratitis.
- Ocular infections with S. pyogenes can lead to severe morbidity if not treated promptly.
Purpose of the Study:
- To characterize risk factors, clinical presentations, management, outcomes, and microbiological properties of Streptococcus pyogenes keratitis.
Main Methods:
- Retrospective review of culture-proven S. pyogenes keratitis cases (2008-2018) at UPMC.
- Analysis of demographic data, ocular history, clinical presentation, antibiotic sensitivity, treatments, and outcomes.
Main Results:
- Six cases reviewed (median age 67, all female).
- Risk factors included prior cataract surgery and contact lens use; two presented with corneal perforation.
- Five isolates were fluoroquinolone-susceptible; all were cefazolin-susceptible. Visual outcomes varied significantly.
Conclusions:
- S. pyogenes is an uncommon ocular pathogen but can cause severe keratitis.
- Infection can occur in patients with no prior ocular issues.
- Cefazolin and fluoroquinolones are effective against most S. pyogenes isolates.
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