This abstract is assigned to sessions
| Presentation preference | Poster presentation |
| Title | Challenges in the Management of Ocular Nontuberculous Mycobacterial Infection: Two Cases |
| Purpose | To describe two ocular cases of nontuberculous mycobacterial (NTM) infection. |
| Methods | Retrospective chart review. |
| Results | 57 year-old man with bilateral retinal detachment, post scleral buckle presented with inflammation, burning and pain OD after a trip to Aruba. Patient diagnosed with scleritis and keratitis with corneal abscess. Mycobacterium abscessus identified after two scleral biopsies and corneal biopsy. Initial therapy was IV vancomycin and ceftazidime, topical azithromycin, amikacin, voriconazole, and oral voriconazole. 2 years later, he is on topical azithromycin, amikacin, prednisolone, oral azithromycin, omadacycline, and intravitreal amikacin. His infection is controlled but unresolved.
62 year-old woman with rheumatoid arthritis on abatacept and leflunomide and Sjögren’s syndrome presented with keratitis and perforated corneal ulcer. The perforation was sealed with glue; the keratitis waxed and waned for 4 months, partly responsive to systemic steroids. Cultures were negative initially, but later AFB stain and culture showed Mycobacterium chelonae. Topical amikacin, moxifloxacin, and oral azithromycin started with good clinical response. |
| Conclusion | NTM infections are usually associated with trauma or corneal refractive surgery. In cases of infectious keratitis and scleritis with unusual presentation and response to treatment, suspect NTM infections. Patients with atypical environmental exposures or immunosuppression are at risk for NTM infection. NTM keratitis and scleritis can be difficult to treat and require chronic multimodal antibiotic therapies. |
| Conflict of interest | No |
Authors 1
| Last name | KIM |
| Initials of first name(s) | E |
| Department | Icahn School of Medicine at Mount Sinai |
| City | New York |
| Country | United States |
Authors 2
| Last name | Chu |
| Initials of first name(s) | KH |
| Department | MERSI |
| City | Palisades Park |
| Country | United States |
Authors 3
| Last name | Chu |
| Initials of first name(s) | DS |
| Department | MERSI |
| City | Palisades Park |
| Country | United States |
