Maticorena-Quevedo Jesus, Patiño-Valderrama Lía, Arellano-Caro Karin
Department of Ophthalmology, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru.
Cornea and External Diseases Unit, Department of Ophthalmology, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru.
Arq Bras Oftalmol. 2023 Jul-Aug;86(4):384-387. doi: 10.5935/0004-2749.20230039.
Bacterial keratitis caused by multidrug-resistant strains of Pseudomonas aeruginosa is a therapeutic challenge due to a limited number of active antimicrobials and rapid progression to corneal necrosis and perforation. To report the use of topical colistin and surgical tarsorrhaphy in a case of keratitis caused by extensively drug-resistant Pseudomonas aeruginosa in a patient with severe coronavirus disease-2019 (COVID-19) pneumonia. A 56-year-old male was admitted to the intensive care unit with clinical symptoms of severe COVID-19 pneumonia. During his stay in the unit, he developed rapidly progressive keratitis with Pseudomonas aeruginosa resistant to all drugs except for colistin on culture. Due to incomplete lid closure, a temporary tarsorrhaphy was performed, and a regimen of descending-dose topical colistin was initiated. After five weeks, keratitis resolved completely. Extensively drug-resistant Pseudomonas aeruginosa is an unusual cause of bacterial keratitis. We describe the safe and effective use of topical colistin in a case with severe corneal involvement.
由多重耐药性铜绿假单胞菌引起的细菌性角膜炎是一项治疗挑战，因为有效的抗菌药物数量有限，且病情会迅速发展为角膜坏死和穿孔。报告在一名患有严重2019冠状病毒病（COVID-19）肺炎的患者中，使用局部用黏菌素和手术睑裂缝合术治疗由广泛耐药性铜绿假单胞菌引起的角膜炎的情况。一名56岁男性因严重COVID-19肺炎的临床症状入住重症监护病房。在他住院期间，他患上了快速进展性角膜炎，培养结果显示铜绿假单胞菌对除黏菌素外的所有药物均耐药。由于眼睑闭合不全，进行了临时睑裂缝合术，并开始使用递减剂量的局部用黏菌素方案。五周后，角膜炎完全消退。广泛耐药性铜绿假单胞菌是细菌性角膜炎的一种不常见病因。我们描述了在一例严重角膜受累病例中局部用黏菌素的安全有效应用。
