Korean J Ophthalmol.  2010 Aug;24(4):240-244. 10.3341/kjo.2010.24.4.240.

Two Cases of Corneal Ulcer due to Methicillin-Resistant Staphylococcus aureus in High Risk Groups

• Lee KM
• Lee HS
• Kim MS

• KMID: 949063
• DOI: http://doi.org/10.3341/kjo.2010.24.4.240

Abstract

Considering the popular use of antibiotic-containing eyedrops in Korea, it is important to know the emerging antibiotic-resistant strains of bacteria before treating infectious eye diseases. This is especially important in high-risk groups because of the high incidence of resistant infections and the subsequent treatment requirements. We report two cases of methicillin-resistant Staphylococcus aureus (MRSA) corneal ulcers in high-risk groups. The first case involved a patient who had keratitis after using antibiotic- and steroid-containing eyedrops to treat a corneal opacity that developed after repeated penetrating keratoplasty. The second case involved a patient who used antibiotic-containing eyedrops and a topical lubricant on a regular basis for >1 month to treat exposure keratitis due to lagophthalmos. The second patient's problems, which included a persistent superficial infiltration, developed after brain tumor surgery. Both cases showed MRSA on corneal culture, and the corneal ulcers improved in both patients after the application of vancomycin-containing eyedrops. In conclusion, MRSA infection should be considered in corneal ulcers that have a round shape, mild superficial infiltration, and slow progression, especially in high-risk groups. This report includes descriptions of the characteristic features, antibiotic sensitivities, prevention, and successful treatment with vancomycin-containing eyedrops for MRSA corneal ulcers.

Keyword

Corneal ulcer; Methicillin-resistant Staphylococcus aureus

MeSH Terms

Cornea/*microbiology/pathology
Corneal Ulcer/diagnosis/*microbiology
Diagnosis, Differential
Eye Infections, Bacterial/diagnosis/*microbiology
Female
Follow-Up Studies
Humans
Male
Methicillin-Resistant Staphylococcus aureus/*isolation & purification
Middle Aged
Staphylococcal Infections/diagnosis/*microbiology