RT Book, Section
A1 Duncan, Jacque L.
A1 Parikh, Neeti B.
A1 Seitzman, Gerami D.
A2 Papadakis, Maxine A.
A2 McPhee, Stephen J.
A2 Rabow, Michael W.
A2 McQuaid, Kenneth R.
SR Print(0)
ID 1193144614
T1 Infectious Keratitis
T2 Current Medical Diagnosis & Treatment 2023
YR 2023
FD 2023
PB McGraw-Hill Education
PP New York, NY
SN 9781264687343
LK accessmedicine.mhmedical.com/content.aspx?aid=1193144614
RD 2024/04/20
AB Risk  factors  for  bacterial  keratitis  include  contact  lens  wear—especially  overnight  wear—and  corneal  trauma,  including  refractive  surgery.  The  pathogens  most  commonly  isolated  are  staphylococci,  including  MRSA;  streptococci;  and  Pseudomonas  aeruginosa,  Moraxella  species,  and  other  gram-negative  bacilli.  The  cornea  has  an  epithelial  defect  and  an  underlying  opacity.  Hypopyon  may  be  present  (eFigure  7–23).  Topical  fluoroquinolones,  such  as  levofloxacin  0.5%,  ofloxacin  0.3%,  norfloxacin  0.3%,  or  ciprofloxacin  0.3%,  are  commonly  used  as  first-line  agents  as  long  as  local  prevalence  of  resistant  organisms  is  low  (Table  7–2).  For  severe  central  ulcers,  diagnostic  scrapings  can  be  sent  for  Gram  stain  and  culture.  Treatment  may  include  compounded  high-concentration  topical  antibiotic  drops  applied  hourly  day  and  night  for  at  least  the  first  48  hours.  Fourth-generation  fluoroquinolones  (moxifloxacin  0.5%  and  gatifloxacin  0.3%)  are  also  frequently  used  in  this  setting.  Although  early  adjunctive  topical  corticosteroid  therapy  may  improve  visual  outcome,  it  should  be  prescribed  only  by  an  ophthalmologist.