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Atypical Mycobacterial Keratitis

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Infections of the Cornea and Conjunctiva

Abstract

Atypical mycobacteria (AM) are aerobic, nonspore-forming bacilli that are known to be involved in many ocular infections, most commonly keratitis. The most common AM organisms that cause keratitis are Mycobacterium chelonae, Mycobacterium fortuitum, and Mycobacterium abscessus. While AM keratitis are commonly associated with post-laser in situ keratomilieusis (LASIK) scenarios, AM keratitis is also frequently caused by trauma and contact lens wear. It is difficult to diagnose AM keratitis because of the clinical appearance as well as the slow growth on culture. Hence, initiation of treatment is often delayed, leading to worse outcomes. Specific stains and cultures in addition to standard media are sometimes needed, including acid-fast stains, Ziehl–Neelsen, Lowenstein–Jensen medium, and Middlebrook 7H9 broth. Many treatment options have been studied, but topical amikacin appears to be one of the most commonly used therapies. Occasionally, systemic antibiotics are used, and in recalcitrant cases with risk to continued spread beyond the cornea, surgical intervention is needed. As clinical outcomes are dependent on a high suspicion for this condition and the initiation of prompt treatment, an understanding of and a recognition of AM keratitis is of utmost importance.

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Authors and Affiliations

  1. Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, MD, USA

    Isa S. K. Mohammed & Bennie H. Jeng

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  1. Isa S. K. Mohammed
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  2. Bennie H. Jeng
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Correspondence to Bennie H. Jeng .

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Editors and Affiliations

  1. Cornea and Anterior Segment Service, L V Prasad Eye Institute, Bhubaneswar, Odisha, India

    Sujata Das

  2. Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Vishal Jhanji

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Mohammed, I.S.K., Jeng, B.H. (2021). Atypical Mycobacterial Keratitis. In: Das, S., Jhanji, V. (eds) Infections of the Cornea and Conjunctiva. Springer, Singapore. https://doi.org/10.1007/978-981-15-8811-2_7

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  • DOI: https://doi.org/10.1007/978-981-15-8811-2_7

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