Demographic study of expulsive hemorrhages in 3 patients with infectious keratitis.

PURPOSE

To investigate the demography, causative bacteria, and clinical findings in 3 patients with expulsive hemorrhage.

METHODS

The clinical records of 3 patients (3 eyes), who developed expulsive hemorrhage because of infectious keratitis and were treated at our hospital between December 2006 and January 2008, were investigated retrospectively.

RESULTS

Three women, older than 70 years, with physical and mental disabilities because of senile dementia were studied. Two were residents at a nursing home. Basic corneal disorders included bullous keratopathy, cicatricial syphilitic keratitis, and traumatic keratitis because of a foreign body. All patients developed expulsive hemorrhage. Two patients underwent enucleation, and 1 underwent bulbar exenteration with sclerocorneal patch for expulsive hemorrhage. Bacterial culture in these cases isolated either Capnocytophaga sp. and penicillin-intermediate resistant Streptococcus pneumoniae or methicillin-resistant Staphylococcus aureus.

CONCLUSIONS

This is the first recorded case of Capnocytophaga keratitis in Japan. Patients with dementia may develop severe ocular complications after infectious keratitis because of their inability to communicate.