Bilateral severe necrotic blepharoconjunctivitis with orbital involvement in a newborn due to Pseudomonas aeruginosa

Abstract

A blepharoconjunctivitis of both eyes in a three-week-old boy, who was treated with Credt's prophylaxis post partum, was the beginning of septicemia. Systemic Mezlocillin, Gentamycin and Cefotaxim therapy was combined with topical antibiotic therapy. Cultures and scrapings taken on multiple occasions were positive for Pseudomonas aeruginosa only. The necrotic infection destroyed the medial canthus, the lacrimal structures, the complete lower eyelid, two-thirds of the upper lid and the temporal canthus of the right eye. The loss of the medial canthal region, the lacrimal passages and the medial thirds of upper and lower eyelid was seen at the left side. The lesions did not respond to systemic therapy with Ceftazidim, Tobramycin, Fosfocin and topical treatment with Tobramycin although the in vitro testing apparently showed good sensibility of the strain to all of them. Lesions progressed to involve the bony structures of the orbit as shown by repeated computer tomography. Ultimately the cornea of the right ...