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Related Experiment Videos

Spontaneous ulcerative keratitis in immunocompromised patients

B Aristimuño1, V S Nirankari, R K Hemady

  • 1Department of Ophthalmology, University of Maryland School of Medicine, Baltimore.

American Journal of Ophthalmology
|February 15, 1993
PubMed
Summary

Intravenous drug abusers, particularly those with HIV/AIDS, face a high risk of severe ulcerative keratitis. Prompt antibiotic and antifungal treatment can heal most corneal ulcers, but some cases may lead to vision loss.

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Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Microbiology

Background:

  • Ulcerative keratitis is a serious eye condition.
  • Intravenous drug abuse is a risk factor for various infections.

Observation:

  • A study examined five eyes of four young female intravenous drug abusers with ulcerative keratitis.
  • Two patients had acquired immunodeficiency syndrome (AIDS), and one was human immunodeficiency virus (HIV)-positive.
  • Corneal ulcers varied in location and microbial cause, including Capnocytophaga, Candida albicans, Streptococcus, Staphylococcus aureus, and Pseudomonas aeruginosa.

Findings:

  • Corneal cultures identified diverse polymicrobial infections and Capnocytophaga species.
  • Treatment with topical fortified antibiotics and antifungals led to complete healing in inferiorly located ulcers.

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  • One case of extensive keratitis resulted in perforation and evisceration, with histopathology showing acute keratitis and necrosis.

    • Implications:

    • This highlights the significant risk of severe ocular infections, including ulcerative keratitis, in intravenous drug users, especially those with HIV/AIDS.
    • Effective treatment strategies involving topical antibiotics and antifungals can achieve healing for many corneal ulcers.
    • Aggressive or atypical presentations may still lead to poor visual outcomes, emphasizing the need for early diagnosis and intervention.