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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Amniotic membrane transplantation in a patient with impending perforated corneal ulcer caused by Streptococcus mitis: A case report and review of literature
Fang-Chi Hsiao, Yaa-Jyuhn James Meir, Lung-Kun Yeh, Hsin-Yuan Tan, Ching-Hsi Hsiao, David Hui-Kang Ma, Wei-Chi Wu, Hung-Chi Chen
Fang-Chi Hsiao, Lung-Kun Yeh, Hsin-Yuan Tan, Ching-Hsi Hsiao, David Hui-Kang Ma, Wei-Chi Wu, Hung-Chi Chen, Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan
Yaa-Jyuhn James Meir, Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan
Lung-Kun Yeh, Hsin-Yuan Tan, Ching-Hsi Hsiao, David Hui-Kang Ma, Wei-Chi Wu, Hung-Chi Chen, Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan
Hung-Chi Chen, Center for Tissue Engineering, Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan
Author contributions: Hsiao FC conducted the literature search, collected the data, interpreted the data, and prepared the manuscript; Meir YJ and Yeh LK collected the data and interpreted the data; Tan HY and Hsiao CH interpreted the data and edited the manuscript; Ma HK and Wu WC interpreted the data and critically revised the draft; Chen HC designed the study, interpreted the data, edited the manuscript, and critically revised the draft.
Informed consent statement: Written informed consent was obtained from the patient for the publication of this case report and any accompanying images.
Conflict-of-interest statement: The authors have no conflicts of interest relevant to this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Hung-Chi Chen, MD, PhD, Professor, Department of Ophthalmology, Chang Gung Memorial Hospital, No. 5, Fuxing Street, Guishan District, Taoyuan 333423, Taiwan. mr3756@cgmh.org.tw
Received: September 21, 2021
Peer-review started: September 21, 2021
First decision: December 27, 2021
Revised: February 3, 2022
Accepted: March 6, 2022
Article in press: March 6, 2022
Published online: April 26, 2022
BACKGROUND
Streptococcus mitis (S. mitis) is an opportunistic pathogen that can lead to severe ocular infections. In previous reports, penetrating keratoplasty (PK) was usually adopted for the treatment of persistent corneal ulcers. This report describes an unusual case of nonhealing descemetocele caused by S. mitis treated by antibiotics plus amniotic membrane transplantation (AMT).
CASE SUMMARY
A 63-year-old woman presented with a right persistent corneal ulcer that she had suffered from for the past 9 mo. The culture of a corneal scraping yielded S. mitis. The right eye descemetocele decreased in diameter from 3 to 0.8 mm after the continuous administration of topical vancomycin and ceftriaxone for 2 wk. Due to the slow healing, AMT was performed. Her corneal erosion healed and gradually became clear. Her visual acuity recovered from initially counting fingers to 100/200 at the last follow-up, 67 mo after AMT.
CONCLUSION
Antibiotics plus AMT may be an effective alternative treatment other than PK to promote epithelialization and to reduce inflammation in the corneas complicated by S. mitis keratitis.
Core Tip: In this case, we described the clinical and treatment course of an impending perforated corneal ulcer caused by Streptococcus mitis (S. mitis). We also demonstrated that treatment with antibiotics and amniotic membrane transplantation was successful, without the need for penetrating keratoplasty, and this could be considered an alternative treatment for nonhealing descemetoceles induced by S. mitis, as compared to the previous treatment.
