This case report describes a case of self-inflicted chronic bacterial keratoconjunctivitis involving the patient's own semen. A 20-year-old male soldier was referred to our clinic for the evaluation of refractory chronic bacterial conjunctivitis. Over the previous 4 months, he had been treated for copious mucous discharge, conjunctival injection, and superficial punctate keratitis in both eyes at an army hospital and a local eye clinic. Despite the use of topical and systemic antibiotics according to the results of conjunctival swab culture, there was no improvement. During the repeated smear and culture of conjunctival swabs, surprisingly, a few sperm were detected on Gram staining, revealing that the condition was self-inflicted bacterial keratoconjunctivitis involving the patient's own semen. Thus, in cases of chronic keratoconjunctivitis that do not respond to appropriate antibiotic treatment, self-inflicted disease or malingering should be considered.
Chronic Disease ; Conjunctiva/*injuries/microbiology/pathology ; Cornea/microbiology/*pathology ; Diagnosis, Differential ; Eye Infections, Bacterial/diagnosis/*etiology/microbiology ; Eye Injuries/*complications/diagnosis ; Humans ; Keratoconjunctivitis/diagnosis/*etiology/microbiology ; Male ; Self Mutilation/*complications/diagnosis ; *Semen ; Young Adult

Phialemonium keratitis is a very rare case and we encountered a case of keratitis caused by Phialemonium obovatum (P. obovatum) after penetrating injury to the cornea. This is the first case report in the existing literature. A 54-year-old male was referred to us after a penetration injury, and prompt primary closure was performed. Two weeks after surgery, an epithelial defect and stromal melting were observed near the laceration site. P. obovatum was identified, and then identified again on repeated cultures. Subsequently, Natacin was administered every two hours. Amniotic membrane transplantation was performed due to a persistent epithelial defect and impending corneal perforation. Three weeks after amniotic membrane transplantation, the epithelial defect had completely healed, but the cornea had turned opaque. Six months after amniotic membrane transplantation, visual acuity was light perception only, and corneal thinning and diffuse corneal opacification remained opaque. Six months after amniotic membrane transplantation, visual acuity was light perception only, and corneal thinning and diffuse corneal opacification remained.
Cornea/*injuries/microbiology/pathology ; Diagnosis, Differential ; Eye Infections, Fungal/diagnosis/etiology/*microbiology ; Eye Injuries, Penetrating/*complications/diagnosis ; Follow-Up Studies ; Fungi/isolation & purification ; Humans ; Keratitis/diagnosis/etiology/*microbiology ; Male ; Middle Aged