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Moraxella corneal ulcers: poor response to medical treatment
Abstract:
Three patients, all chronic alcoholics, had corneal ulcers caused by two Moraxella species. The diagnosis was suspected from the Gram's stain in two cases and confirmed by culture in all three. In spite of aggressive and appropriate medical management, all three cases required surgical intervention. Two patients underwent penetrating keratoplasty for perforation or descemetocele, and one received a conjunctival flap. Moraxella corneal ulcers often do not respond well to medical treatment. As these organisms are highly susceptible to antibiotics in vitro, host factors must play a role in the poor prognosis of these infections.
Insights
Chronic alcoholics with Moraxella corneal ulcers often require surgery despite medical treatment. Host factors likely contribute to poor outcomes in these serious eye infections.
Area of Science:
- Ophthalmology
- Microbiology
Background:
- Corneal ulcers are a significant cause of vision loss.
- Moraxella species are Gram-negative bacteria that can cause ocular infections.
Observation:
- Three chronic alcoholic patients presented with corneal ulcers.
- Diagnosis was confirmed by Gram's stain and culture.
- All patients required surgical intervention despite medical management.
Findings:
- Moraxella species were identified as the causative agents.
- Surgical interventions included penetrating keratoplasty and conjunctival flap.
- In vitro antibiotic susceptibility did not correlate with clinical response.
Implications:
- Moraxella corneal ulcers in chronic alcoholics have a poor prognosis.
- Host factors, potentially related to alcoholism, may impair healing.
- Further research into host-pathogen interactions is warranted.