1.Atypical Contact Lens Related Corneal Ulcer Caused by Pasteurella Multocida
Fatin Hanisah F ; Umi Kalthum MN ; Rona Asnida N ; Jemaima CH
Journal of Surgical Academia 2018;8(1):43-46
		                        		
		                        			
		                        			A  55-year-old  healthy  lady  withhistory  of  regular  contact  lens  (CL)  use  presented  with  10  days  history  of progressive  left  eye  blurring  of  vision,  redness  and  pain.  There  was  good  CL  hygiene  practiced  with  no  history  of swimming,  trauma  or  contact  with  domestic  pets.  Left  eye  vision  was  hand  movement  and  right  eye  was  1/60, pinhole  6/18.  On  the  left  eye,  there  was  a  central,  oval-shaped  corneal  infiltrate  with  an  overlying  large  epithelial defect and stromal oedema, with significant anterior chamber cells and fibrin. B-mode ultrasound showed no vitritis. Intensive  topical  benzylpenicillin  10000iu/ml  and  topical  gentamycin  1.4%  hourly,  homatropine  2%  three  times daily,  oral  doxycycline  and  oral  ascorbic  acid  were  started.  The  gram  stain  results  showed  gram  positive  cocci growth.  Her  ulcerimproved   with  the  treatment  and  preservative-free  dexamethasone  0.1%  once  daily   was commenced  to  reduce  inflammation  and  scarring.  Interestingly,  culture  was  reported  as Pasteurella  maltocida,  a gram  negative  bacilli  sensitive  to  penicillin,  and  so  treatment  was  continued  until  the  ulcer  completely  healed.  She had central corneal scarring with best corrected vision of 6/24 in the left eye but was not keen on further surgery to improve  her  vision.  Although  it  has  not  been  previously  reported, Pasteurella  multocidacan  cause  CL  related corneal ulcer with severe anterior chamber inflammation. This diagnosis should be considered even if there is trivial contact or no history of exposure to domestic animals.
		                        		
		                        		
		                        		
		                        	
            
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