ESCRS - P239 - SEVERE INFECTIOUS KERATITIS REVEALING AN HIV INFECTION IN A 2 MONTHS OLD INFANT

SEVERE INFECTIOUS KERATITIS REVEALING AN HIV INFECTION IN A 2 MONTHS OLD INFANT

Published 2022 - 26th ESCRS Winter Meeting

Reference: P239 | Type: Abstracts | DOI: 10.82333/0vbn-ss52

Authors: Hind Hamdani* 1 , Omar Nabih 1 , Manal Samie 1 , Loubna El Maaloum 1 , Bouchra Allali 1 , Asmaa El Kettani 1

1Pediatric. ophtalmology,Hôpital 20 Août,Casablanca,Morocco

Purpose

Infectious keratitis is a medical emergency. 

We report the case of a retroviral infection revealed by a corneal abscess and the importance of the general examination of the infant. 

Setting

Pediatric ophtalmology department, Hopital 20 Août 1953 Casablanca Morocco

Methods

 
We report the case of a 2 month old infant who was treated for an acute intussusception and who presented with a red right eye 3 days prior to his consultation. 

 

Results

 
Ophthalmological examination of the infant revealed a red right eye with purulent secretions and a subtotal corneal abscess complicated by descemetocele. 
Examination of the contralateral eye was unremarkable. 
A corneal sampling with removal of the fibrin was performed under sedation, and a treatment based on vancomycin and ceftazidime fortified eye drops was started with a local hypotensive drops. When the patient did not improve, fluconazole-based antifungal eye drops were introduced 48 hours later. 
Bacteriological, parasitological and fungal results were negative. 
The patient presented respiratory distress 5 days after hospitalisation and was transferred to the intensive care unit. A Covid-19 infection was ruled out, as well as cardiac pathology. In view of the non-improvement and the onset of a fever of 39°C, an immune check-up was carried out, revealing an HIV infection. 
An antiviral treatment was started but unfortunately the evolution resulted in the death of the patient.  
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Ophthalmological examination of the infant revealed a red right eye with purulent secretions and a subtotal corneal abscess complicated by descemetocele. Examination of the contralateral eye was unremarkable. A corneal sampling with removal of the fibrin was performed under sedation, and a treatment based on vancomycin and ceftazidime fortified eye drops was started with a local hypotonant. When the patient did not improve, fluconazole-based antifungal eye drops were introduced 48 hours later. Bacteriological, parasitological and fungal results were negative. The patient presented respiratory distress 5 days after hospitalisation and was transferred to the intensive care unit. A Covid-19 infection was ruled out, as well as cardiac pathology. In view of the non-improvement and the onset of a fever of 39°C, an immune check-up was carried out, revealing an HIV infection. An antiviral treatment was started but unfortunately the evolution resulted in the death of the patient.  

 

Conclusion

Infectious keratitis is a major global cause of visual impairment and blindness. In infants it usually complicates a known or unnoticed trauma. However, the general examination of the infant should not be overlooked as other signs may be present that point to an aetiology, as in our case.