Abstract
Corneal ulcers may become non-healing if inappropriately managed. Empirically giving broad spectrum antibiotics or prescription of a “cocktail” of topical antibacterial, antifungal and antiviral medication may only add to drug toxicity and drug resistance. We present a series of four cases of microbial keratitis which are complicated due to presence of more than one causative organism. Microbiological work-up revealed Proteus species and fungal hyphae in smears only in the first case, atypical Mycobacteria and Staphyloccocus species in the second case, Moraxella and Streptococcus viridans in the third case and Aspergillus flavus and Nocardia species in the fourth case. Authors would like to emphasize the need for laboratory support in the treatment of corneal ulcers and importance of proper management of this sight threatening disease.
Highlights
Microbial keratitis is one of the main causes of corneal blindness especially in the developing country
Giving broad spectrum antibiotics or prescription of a “cocktail” of topical antibacterial, antifungal and antiviral medication may only add to drug toxicity and drug resistance
We present a series of four cases of microbial keratitis which are complicated due to presence of more than one causative organism
Summary
Microbial keratitis is one of the main causes of corneal blindness especially in the developing country. Either due to lack of laboratory support, or due to paucity of time in a busy clinic, availability of broad spectrum topical antibiotics or various other reasons, patient receives a “cocktail” of topical and systemic medications usually in inadequate dosages. This leads to the organism(s) developing resistance to the drug(s) and in addition, there is damage to the ocular surface due to drug toxicity. We present a series of non-healing microbial keratitis where proper microbiological work-up helps in detecting more than one organism in each of these ulcers as the causative factors
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