Posters

Bilateral bacterial keratitis in a critically ill and intubated patient in an intensive care unit: case report

Poster Details

First Author: C.Chen TAIWAN

Co Author(s):                        

Abstract Details

Purpose:

To introduce a case with severe bilateral pseudomonas keratitis due to aerosol inoculation in the intensive care unit (ICU) and further discussion of eye care treatment for critical ill patient in the ICU setting

Setting:

case study

Methods:

case report

Results:

This 49-year-old female with past history of thyroid eye disease who suffered from intracranial hemorrhage and was admitted to ICU after urgent craniotomy. Patient was intubated and under sedation after surgery. Slit lamp exam demonstrated large inferior corneal epithelial defects and dellen (OU). Under the impression of microbial keratitis, corneal specimen was obtained and sent for gram stain and culture. Patient was treated with broad spectrum fortified antibiotic eyedrops (vancomycin and ceftazidime). Corneal and sputum cultures both confirm the diagnosis of same pseudomonas infection. Her ocular condition improved gradually with topical fortified anti-pseudomonas antibiotics and temporary tarsorrhaphy.

Conclusions:

In the ICUs, sedated patients are unable to convey ophthalmologic complaints, also treatment is usually focused on the management of life-threatening disease, and ocular conditions are frequently overlooked . However, ocular surface disorder is not rare in the ICU, with its severity ranging from mild exposure keratopathy to vision-threatening disorders. Lack of awareness of the risk and failure of regular ocular screening mean that ophthalmologic disorders may go unrecognized. A standard eyecare protocol with prompt identification of the risks, including lagophthalmos, mechanical ventilation and open suction system are essential to prevent severe corneal complications in these patients.

Financial Disclosure:

None