Rare case of bilateral perforated corneal ulcer due to gonococcal infection, managed with temporary periosteal graft

Samira, Nuriadara; Bani, Anna Puspitasari; Susiyanti, Made

doi:10.1136/bcr-2015-213547

Cited by 8 publications

(5 citation statements)

References 5 publications

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“…Anecdotally, various materials (autologous or exogenous) have been used to treat a corneal perforation, such as autologous lamellar scleral flaps, periosteal grafts from the anterior tibial crest, pericardium or even multilayer Gore-Tex patches [21][22][23]. These were obviously selected in the absence of other solutions in a moment of crisis, and mainly occurs in developing countries that are deficitary in donor tissues.…”

Section: Other Autologous and Exogenous Graftsmentioning

confidence: 99%

Update on surgical management of corneal ulceration and perforation

Stamate¹,

Tătaru²,

Zemba³

2019

rjo

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Corneal ulcerations are a medical emergency, and in recalcitrant cases, leading to perforation, a surgical ophthalmological emergency. The urgency of the treatment is dictated by the necessity of preventing complications that can lead to serious ocular morbidities. Medical treatment represents the first therapeutic approach and is a defining step in the further management of a patient with corneal ulceration. Multiple surgical strategies are available, but the option depends on the etiology and parameters of the ulceration: size, depth, and location.

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Section: Other Autologous and Exogenous Graftsmentioning

confidence: 99%

Update on surgical management of corneal ulceration and perforation

Stamate¹,

Tătaru²,

Zemba³

2019

rjo

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“…A rapid progression of gonococcal infection leads to a rapid loss of visual acuity [ 34 ]. Moreover, established infection must be rapidly eliminated to reduce the severity of vision loss and the potential need for ocular grafts [ 43 , 44 ]. The application of monocaprin could be a prophylaxis that halts gonococcal growth and colonization through its antimicrobial action, and therefore, such a prophylaxis would prevent the development of purulent discharge symptoms from neutrophils failing to clear the infection.…”

Section: Resultsmentioning

confidence: 99%

The Growing Threat of Gonococcal Blindness

et al. 2018

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Antibiotic-resistant gonorrhea is now a reality, as well as the consequences of untreatable infections. Gonococcal eye infections result in blindness if not properly treated; they accounted for the vast majority of infections in children in homes for the blind in the pre-antibiotic era. Neisseria gonorrhoeae infects the eyes of infants born to mothers with gonorrhea and can also infect the eyes of adults. Changes in sexual practices may account for the rise in adult gonococcal eye infections, although some cases seem to have occurred with no associated genital infection. As gonorrhea becomes increasingly difficult to treat, the consequences for the treatment of gonococcal blindness must be considered as well. Monocaprin was shown to be effective in rapidly killing N. gonorrhoeae, and is non-irritating in ocular models. Repeated passage in sub-lethal monocaprin induces neither resistance in gonococci nor genomic mutations that are suggestive of resistance. Here, we show that 1 mM monocaprin kills 100% of N. gonorrhoeae in 2 min, and is equally effective against N. meningitidis, a rare cause of ophthalmia neonatorum that is potentially lethal. Monocaprin at 1 mM also completely kills Staphylococcus aureus after 60 min, and 25 mM kills 80% of Pseudomonas aeruginosa after 360 min. Previously, 1 mM monocaprin was shown to eliminate Chlamydia trachomatis in 5 min. Monocaprin is, therefore, a promising active ingredient in the treatment and prophylaxis of keratitis, especially considering the growing threat of gonococcal blindness due to antimicrobial resistance.

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“…Selain itu, penggunaan periosteal graft pada kasus perforasi kornea juga diketahui mampu membangun integritas struktural bola mata (memiliki kemampuan tektonik yang baik), dapat menghindari kondisi endoftalmitis sekunder, mudah tervaskularisasi oleh jaringan disekitarnya, serta memiliki potensi rendah penolakan cangkok yang diperantarai sistem imun resipien. (17) Hasil periosteal graft pasca tindakan operasi dapat dilihat pada Gambar 2.…”

Section: Pembahasanunclassified

Ulkus Kornea Perforasi Sebagai Dampak Penggunaan Steroid Tanpa Indikasi: Sebuah Laporan Kasus

Vilado¹,

Herwindo²,

David³

et al. 2022

JK-RISK

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Ulkus kornea merupakan suatu kondisi infeksi kornea yang melibatkan lapisan epitel hingga stroma. Penggunaan steroid tanpa indikasi masih menjadi hal yang masif di fasilitas kesehatan tingkat pertama (FKTP) serta berpotensi mengakibatkan berbagai komplikasi. Steroid dapat menunda penyembuhan epitel dan dapat menginduksi terjadinya perforasi, serta inhibisi neutrofil sehingga dapat mengeksaserbasi infeksi. Pemahaman secara holistik mengenai ulkus kornea terutama pendekatan diagnosis baik secara klinis maupun penunjang hingga manajemen efektif bagi pasien sangat penting untuk dipahami oleh setiap dokter terutama pada pelayanan FKTP. Tujuan dari laporan kasus ini adalah untuk memberikan pengetahuan terkait penegakan diagnosis, tatalaksana steroid dan penggunaan periosteal graft pada ulkus kornea yang sudah mengalami perforasi. Seorang pria berusia 39 tahun datang ke RSUD Dr. Saiful Anwar Malang (RSSA) dengan keluhan mata kiri kemerahan, nyeri, dan muncul lesi berwarna putih yang meluas. Keluhan tersebut muncul pada mata kiri setelah terkena pelepah pisang satu bulan yang lalu. Awalnya hanya muncul bintik putih dan kemudian meluas. Pasien telah mendapat pengobatan dari FKTP dan Fasilitas Kesehatan Tingkat Lanjutan (FKTL) namun dirujuk ke RSSA karena terdapat potensi komplikasi. Pendekatan diagnosis secara holistik dan penatalaksanaan yang tepat indikasi penting untuk mencegah komplikasi ulkus kornea khususnya dalam penggunaan steroid.

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Rare case of bilateral perforated corneal ulcer due to gonococcal infection, managed with temporary periosteal graft

Cited by 8 publications

References 5 publications

Update on surgical management of corneal ulceration and perforation

Update on surgical management of corneal ulceration and perforation

The Growing Threat of Gonococcal Blindness

Ulkus Kornea Perforasi Sebagai Dampak Penggunaan Steroid Tanpa Indikasi: Sebuah Laporan Kasus

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