Korean J Ophthalmol.  2013 Dec;27(6):459-462. 10.3341/kjo.2013.27.6.459.

Self-inflicted Chronic Bacterial Keratoconjunctivitis Using Self Semen

• Eom Y
• Kim YH
• Kim SH
• Kim HM
• Song JS

• KMID: 1792083
• DOI: http://doi.org/10.3341/kjo.2013.27.6.459

Abstract

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.

Keyword

Keratoconjunctivitis; Malingering; Self-inflicted disease

MeSH Terms

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

Figure

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  Fig. 1 The external photographs of the patient at the first visit. Severe conjunctival hyperemia is observed on both upper (A) and lower (B) bulbar conjunctiva.

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  Fig. 2 Sticky mucous discharge (arrow) on both eyes.

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  Fig. 3 A few sperm (arrow) are observed on Gram staining.

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