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Nonulcerating bacterial keratitis associated with soft and rigid contact lens wear.
Ophthalmology. 1998 Mar; 105(3):517-21.O

Abstract

OBJECTIVE

An unusual presentation of contact lens-related bacterial keratitis is that of epithelial nodular infiltrates and stromal inflammation without epithelial ulceration. The authors study the initial diagnosis, clinical features, causative organisms, and outcomes of corneal infections presenting in this manner.

DESIGN

The study design was a 20-month retrospective chart review.

PARTICIPANTS

Five patients with culture-proven bacterial keratitis who had predominantly nodular epithelial lesions were studied.

RESULTS

Four infections were associated with soft contact lens wear and one with rigid lens wear. All patients had largely intact epithelium; typical gray-colored epithelial nodules, some with underlying anterior stromal haze; and diffuse, fine, cellular stromal inflammation. Two patients were referred with the tentative diagnosis of Acanthamoeba infection and two as contact lens-related sterile keratitis. Epithelial cultures from three cases yielded Serratia sp., one yielded Corynebacterium, and one Streptococcus pneumoniae. All responded to antibacterial medication; final corrected visual acuity in all cases was 20/30 or better.

CONCLUSIONS

Bacterial infection associated with contact lens wear can be established within the corneal epithelium without initially producing an ulcer. A wide range of both gram-positive and gram-negative organisms can be involved. Early recognition and treatment appear to result in a favorable outcome.

Authors+Show Affiliations

Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

9499784

Citation

McLeod, S D., et al. "Nonulcerating Bacterial Keratitis Associated With Soft and Rigid Contact Lens Wear." Ophthalmology, vol. 105, no. 3, 1998, pp. 517-21.
McLeod SD, Goei SL, Taglia DP, et al. Nonulcerating bacterial keratitis associated with soft and rigid contact lens wear. Ophthalmology. 1998;105(3):517-21.
McLeod, S. D., Goei, S. L., Taglia, D. P., & McMahon, T. T. (1998). Nonulcerating bacterial keratitis associated with soft and rigid contact lens wear. Ophthalmology, 105(3), 517-21.
McLeod SD, et al. Nonulcerating Bacterial Keratitis Associated With Soft and Rigid Contact Lens Wear. Ophthalmology. 1998;105(3):517-21. PubMed PMID: 9499784.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nonulcerating bacterial keratitis associated with soft and rigid contact lens wear. AU - McLeod,S D, AU - Goei,S L, AU - Taglia,D P, AU - McMahon,T T, PY - 1998/3/21/pubmed PY - 1998/3/21/medline PY - 1998/3/21/entrez SP - 517 EP - 21 JF - Ophthalmology JO - Ophthalmology VL - 105 IS - 3 N2 - OBJECTIVE: An unusual presentation of contact lens-related bacterial keratitis is that of epithelial nodular infiltrates and stromal inflammation without epithelial ulceration. The authors study the initial diagnosis, clinical features, causative organisms, and outcomes of corneal infections presenting in this manner. DESIGN: The study design was a 20-month retrospective chart review. PARTICIPANTS: Five patients with culture-proven bacterial keratitis who had predominantly nodular epithelial lesions were studied. RESULTS: Four infections were associated with soft contact lens wear and one with rigid lens wear. All patients had largely intact epithelium; typical gray-colored epithelial nodules, some with underlying anterior stromal haze; and diffuse, fine, cellular stromal inflammation. Two patients were referred with the tentative diagnosis of Acanthamoeba infection and two as contact lens-related sterile keratitis. Epithelial cultures from three cases yielded Serratia sp., one yielded Corynebacterium, and one Streptococcus pneumoniae. All responded to antibacterial medication; final corrected visual acuity in all cases was 20/30 or better. CONCLUSIONS: Bacterial infection associated with contact lens wear can be established within the corneal epithelium without initially producing an ulcer. A wide range of both gram-positive and gram-negative organisms can be involved. Early recognition and treatment appear to result in a favorable outcome. SN - 0161-6420 UR - https://www.unboundmedicine.com/medline/citation/9499784/Nonulcerating_bacterial_keratitis_associated_with_soft_and_rigid_contact_lens_wear_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(98)93036-6 DB - PRIME DP - Unbound Medicine ER -