Complicated case of Mycobacterium abscessus conjunctivitis in Sjögren's syndrome
Purpose: To report a case of conjunctivitis due to Mycobacterium abscessus in the setting of keratoconjunctivitis sicca due to Sjögren's syndrome in the absence of other known risk factors such as surgery, trauma or immunosuppressive therapy. Observations: A 61-year-old woman with a history of...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-09-01
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| Series: | American Journal of Ophthalmology Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S245199362030116X |
| _version_ | 1818883525605064704 |
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| author | Caleb Shumway Sahil Aggarwal Steven T. Park Matthew Wade Sanjay Kedhar |
| author_facet | Caleb Shumway Sahil Aggarwal Steven T. Park Matthew Wade Sanjay Kedhar |
| author_sort | Caleb Shumway |
| collection | DOAJ |
| description | Purpose: To report a case of conjunctivitis due to Mycobacterium abscessus in the setting of keratoconjunctivitis sicca due to Sjögren's syndrome in the absence of other known risk factors such as surgery, trauma or immunosuppressive therapy. Observations: A 61-year-old woman with a history of keratoconjunctivitis sicca secondary to Sjögren's syndrome presented with dryness, irritation, redness, and discharge in her left eye for 2 months. She was diagnosed with chronic conjunctivitis and began a regimen of moxifloxacin and an ocular ointment of dexamethasone, neomycin, and polymyxin with no improvement of symptoms. Concurrent cultures grew Mycobacterium abscessus and the patient began treatment with amikacin drops, oral clarithromycin and intravenous imipenem, followed by amikacin drops, oral clarithromycin, and oral clofazimine, but her course was complicated by a perforated corneal ulcer that required a corneal patch graft. The patient eventually recovered despite persistent colonization. Conclusions/importance: We present a case of Mycobacterium abscessus conjunctivitis in a patient with keratoconjunctivitis sicca secondary to Sjögren's syndrome without previous history of surgery, trauma, or other known risk factors. Because of low suspicion and clinician awareness, ocular nontuberculous mycobacteria (NTM) infection may have a delayed diagnosis and treatment. Clinicians should consider NTM in the differential diagnosis in patients with autoimmune disease such as Sjögren's syndrome. Treatment may be lengthy, requiring topical and systemic antibiotics and is often complicated due to resistance. |
| first_indexed | 2024-12-19T15:35:02Z |
| format | Article |
| id | doaj.art-880853b58e584bda9c7024edeaee734e |
| institution | Directory Open Access Journal |
| issn | 2451-9936 |
| language | English |
| last_indexed | 2024-12-19T15:35:02Z |
| publishDate | 2020-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Ophthalmology Case Reports |
| spelling | doaj.art-880853b58e584bda9c7024edeaee734e2022-12-21T20:15:37ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362020-09-0119100765Complicated case of Mycobacterium abscessus conjunctivitis in Sjögren's syndromeCaleb Shumway0Sahil Aggarwal1Steven T. Park2Matthew Wade3Sanjay Kedhar4John A. Moran Eye Center, University of Utah, Salt Lake City, 84132, United StatesGavin Herbert Eye Institute, University of California, Irvine, 92697, United StatesDivision of Infectious Diseases, University of California, Irvine Medical Center, United StatesGavin Herbert Eye Institute, University of California, Irvine, 92697, United StatesGavin Herbert Eye Institute, University of California, Irvine, 92697, United States; Corresponding author. Ocular Immunology and Uveitis Service, Ophthalmology, Gavin Herbert Eye Institute, University of California, Irvine, 850 Health Sciences Road, Irvine, CA, United States.Purpose: To report a case of conjunctivitis due to Mycobacterium abscessus in the setting of keratoconjunctivitis sicca due to Sjögren's syndrome in the absence of other known risk factors such as surgery, trauma or immunosuppressive therapy. Observations: A 61-year-old woman with a history of keratoconjunctivitis sicca secondary to Sjögren's syndrome presented with dryness, irritation, redness, and discharge in her left eye for 2 months. She was diagnosed with chronic conjunctivitis and began a regimen of moxifloxacin and an ocular ointment of dexamethasone, neomycin, and polymyxin with no improvement of symptoms. Concurrent cultures grew Mycobacterium abscessus and the patient began treatment with amikacin drops, oral clarithromycin and intravenous imipenem, followed by amikacin drops, oral clarithromycin, and oral clofazimine, but her course was complicated by a perforated corneal ulcer that required a corneal patch graft. The patient eventually recovered despite persistent colonization. Conclusions/importance: We present a case of Mycobacterium abscessus conjunctivitis in a patient with keratoconjunctivitis sicca secondary to Sjögren's syndrome without previous history of surgery, trauma, or other known risk factors. Because of low suspicion and clinician awareness, ocular nontuberculous mycobacteria (NTM) infection may have a delayed diagnosis and treatment. Clinicians should consider NTM in the differential diagnosis in patients with autoimmune disease such as Sjögren's syndrome. Treatment may be lengthy, requiring topical and systemic antibiotics and is often complicated due to resistance.http://www.sciencedirect.com/science/article/pii/S245199362030116XMycobacteriumConjunctivitisSjögren's syndrome |
| spellingShingle | Caleb Shumway Sahil Aggarwal Steven T. Park Matthew Wade Sanjay Kedhar Complicated case of Mycobacterium abscessus conjunctivitis in Sjögren's syndrome American Journal of Ophthalmology Case Reports Mycobacterium Conjunctivitis Sjögren's syndrome |
| title | Complicated case of Mycobacterium abscessus conjunctivitis in Sjögren's syndrome |
| title_full | Complicated case of Mycobacterium abscessus conjunctivitis in Sjögren's syndrome |
| title_fullStr | Complicated case of Mycobacterium abscessus conjunctivitis in Sjögren's syndrome |
| title_full_unstemmed | Complicated case of Mycobacterium abscessus conjunctivitis in Sjögren's syndrome |
| title_short | Complicated case of Mycobacterium abscessus conjunctivitis in Sjögren's syndrome |
| title_sort | complicated case of mycobacterium abscessus conjunctivitis in sjogren s syndrome |
| topic | Mycobacterium Conjunctivitis Sjögren's syndrome |
| url | http://www.sciencedirect.com/science/article/pii/S245199362030116X |
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