An unusual case of bilateral conjunctival ulcer post dengue fever: A case report

Abstract

A 25-year-old male patient presented with redness and pain in both eyes since 2 days with history of fever in the past 1 week and tested positive for dengue. On examination, the patient had bilateral nasal congestion and a whitish-yellow lesion in the right eye canthal region measuring 4 mm × 4 mm and 2 mm × 1 mm in the left eye; the lesion was fluorescein stain-positive. A provisional diagnosis of bilateral conjunctival ulcer was made and sent for culture and sensitivity. Culture revealed mixed bacterial and fungal growth of Pseudomonas aeruginosa and Aspergillus niger. The patient was started on fortified vancomycin 50 mg/mL (5%) and ceftazidime 50 mg/dL (5%) along with natamycin 5% eyedrops and oral ketoconazole 200 mg. The patient reviewed after 5 days showed fluorescein stain-negativity in both eyes and was completely asymptomatic on further follow-up. Opportunistic infections are common in dengue fever and should be treated aggressively to prevent further ocular complications.