Document Detail


Secondary pseudomonas infection of fungal keratitis following use of contaminated natamycin eye drops: a case series.
MedLine Citation:
PMID:  18820656     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To report a five case of secondary pseudomonas infection of fungal keratitis following use of contaminated natamycin eye drops. METHODS: A retrospective analysis of the course and clinical outcomes of five eyes of five patients with clinical and laboratory-confirmed fungal keratitis species was performed. Clinical worsening despite hourly topical 5% natamycin drops prompted a repeat corneal scraping and microbiological evaluation. RESULTS: The causative fungi for the initial keratitis were Fusarium and Aspergillus species. All the five specimens obtained from repeat scrapings revealed Pseudomonas aeruginosa. The cultures obtained from the natamycin eye drops being used by the patients also grew pseudomonas. On further evaluation, the source of contamination of the natamycin containers was obscure but speculated to be nosocomial, being within the hospital or the pharmacy. All patients had a poor visual outcome with one requiring evisceration because of panophthalmitis, whereas three underwent therapeutic keratoplasty. CONCLUSIONS: A high index of suspicion is recommended in all cases of worsening fungal keratitis to identify secondary contamination of antifungal agents with nosocomial infections.
Authors:
T Krishnan; S Sengupta; P R Reddy; R D Ravindran
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2008-09-26
Journal Detail:
Title:  Eye (London, England)     Volume:  23     ISSN:  1476-5454     ISO Abbreviation:  Eye (Lond)     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-02-13     Completed Date:  2010-01-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8703986     Medline TA:  Eye (Lond)     Country:  England    
Other Details:
Languages:  eng     Pagination:  477-9     Citation Subset:  IM    
Affiliation:
Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Pondicherry, India. tiru@pondy.aravind.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Antifungal Agents / therapeutic use*
Drug Contamination
Eye Infections, Fungal / complications,  drug therapy*
Humans
Keratitis / complications,  drug therapy*
Male
Natamycin / therapeutic use*
Ophthalmic Solutions
Pseudomonas Infections / etiology*
Pseudomonas aeruginosa*
Chemical
Reg. No./Substance:
0/Antifungal Agents; 0/Ophthalmic Solutions; 7681-93-8/Natamycin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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