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Fulminant Pseudomonal Keratitis and Scleritis in Human Immunodeficiency Virus-Infected Patients
Mohit Nanda, MD;
Stephen C. Pflugfelder, MD;
Simon Holland, MD
Arch Ophthalmol. 1991;109(4):503-505.
Abstract
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• Patients with human immunodeficiency virus infection are predisposed to fungal, parasitic, and viral infections. Bacterial infection can also be seen, although ocular bacterial infections have not been reported in patients with acquired immunodeficiency syndrome until recently. We present two cases of Pseudomonas corneoscleritis and one case of Pseudomonas keratitis in patients with human immunodeficiency virus infection that failed to respond to antibiotic treatment. Predisposing factors included extended-wear soft contact lens use in one patient and exposure secondary to Bell's palsy in another patient. All three patients had neutropenia that may have contributed to their poor response to treatment. Enucleation was required to treat two patients with overwhelming infection. Enucleation has been rarely required for treatment of corneoscleritis in immunocompetent patients treated at our institution. Pseudomonas keratitis in human immunodeficiency virus-infected patients represents a serious ocular infection requiring early diagnosis and aggressive treatment.
Author Affiliations
From the Bascom Palmer Eye Institute, University of Miami (Fla) School of Medicine.
Footnotes
Accepted for publication November 13, 1990.
Read before the meeting of the Ocular Microbiology and Immunology Group, New Orleans, La, October 28, 1989.
Reprint requests to Bascom Palmer Eye Institute, Department of Ophthalmology, PO Box 016880, Miami, FL 33101 (Dr Pflugfelder).
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