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Mycobacterium fortuitum keratitis.

P U Dugel1, G N Holland, H H Brown

  • 1UCLA School of Medicine, Jules Stein Eye Institute, Los Angeles, CA 90024-1771.

American Journal of Ophthalmology
|June 15, 1988
PubMed
Summary

Mycobacterium fortuitum keratitis, often linked to corneal surgery or contact lens use, requires rapid diagnosis. Early treatment and avoiding corticosteroids improve outcomes, with surgery potentially restoring vision in advanced cases.

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Area of Science:

  • Ophthalmology
  • Microbiology

Background:

  • Mycobacterium fortuitum is an opportunistic pathogen that can cause severe ocular infections.
  • Keratitis due to M. fortuitum presents a diagnostic and therapeutic challenge.

Observation:

  • Four cases of M. fortuitum keratitis are presented, with varied etiologies including post-surgical, contact lens-related, and foreign body injury.
  • Clinical presentation included pain, conjunctival hyperemia, stromal inflammation, and ulceration.

Findings:

  • Diagnosis was confirmed via corneal scrapings using acid-fast staining and culture.
  • Topical amikacin showed limited efficacy in some cases, with persistent infection noted even after clinical response.
  • Early disease was successfully treated with debridement alone.
  • Rapid diagnosis and avoidance of corticosteroids were critical for successful therapy.

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Implications:

  • Prompt diagnosis and appropriate antimicrobial selection are crucial for managing M. fortuitum keratitis.
  • Penetrating keratoplasty may be necessary for vision restoration in advanced or refractory cases.
  • Understanding risk factors like corneal surgery and contact lens wear is vital for prevention.