Úlcera de córnea por Serratia marcescens após ceratoplastia penetrante

Reschini, Rosa Maria; José, Newton Kara; E. Leite Arieta, Carlos

doi:10.5935/0004-2749.19910005

RESUMO

Relataram-se dois casos de úlcera corneana por Serratia marcescens após transplante de córnea. Os dois pacientes receberam córneas de um mesmo doador, conservadas por 24 horas em meio Dexsol e foram operados em hospitais diferentes, por diferentes cirurgiões.

Os dois pacientes foram retransplantados. Um deles apresentou recidiva da úlcera de córnea por Serratia, e foi submetido a recobrimento conjuntival. O outro paciente evoluiu com opacificação e vascularização do segundo enxerto.

Discute-se o mau prognóstico nos casos de úlcera de córnea por Serratia marcescens e a possibilidade da córnea doadora ser a fonte de infecção em transplantes de córnea.

Palavras-chave:
Infecção após transplante de córnea; córnea doadora; meio de conservação; Serratia marcescens

SUMMARY

Two cases of Serratia marcescens keratitis after corneal transplantation are related. The two patients received cornea from the same donor, preserved in Dexsol medium for 24 hours and had been operated in different hospitals by different surgeons.

A repeat corneal transplantation was performed in both patients. Recurrent Serratia keratitis occured in one of the cases and a conjunctival flap was performed. The other patient developed total opacity and vascularization of the second graft.

The bad prognosis in cases of Serratia marcescens keratitis and the possibility of donor cornea as source of infection are discussed.

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REFERÊNCIAS BIBLIOGRÁFICAS

¹
BAER, J.C.; NIRANKW, V.S.; GLAROS, D.S. - Streptococcal endophthalmitis from contamined donor corneas after keratoplasty. Arch. Ophthalmol. 106: 517-520, 1988.
²
BECHARA, S.J.; CASTANHEIRA, V.R.C.; BONATTI, J.A.; KARA JOSÉ, N.; MYUNG, J.R; NEMER, R.S. - Incidência e profilaxia de endoftalmites em transplantes de córnea. Rev. Bras. Oftalmol. 46: 23-27, 1987.
³
BRINSER, J.H. - Ocular bacteriology. In: TABBARA, K.F. & HYNDIUK, R.A. - Infections of the eye. Boston, Little-Brown, 1986. p. 135.
⁴
CHITIUM, M.E.; GUTZMARKER, R.D.; OILAND, D.M.; KALINA, E. - Contamination of corneal tissue from infected donors. Arch. Ophthalmol. 103: 802-804, 1985.
⁵
CHRISTENSON, J.; KASTIL, P.R.; CALDWELL, D.R. - Bacterial contamination of donor corneas stored in McCarey-Kaufman medium. Ophthalmic Surg. 13: 231-233, 1982.
⁶
FONG, L.P.; OMEROD, L.D.; KENION, K.R; FOSTER, C.J. - Microbial keratitis complicating penetrating keratoplasty. Ophthalmology, 95: 1269-1275, 1988.
⁷
GANDHI, S.S.; LAMBERTS, D.W.; PERRY, H. - Donor to host transmition of disease via corneal transplantation. Surv. Ophthalmol. 25: 306-311, 1981.
⁸
GUSS, R.B.; KOENIG, S.; PENA, W.; MARX, M.; KAUFMAN, H.E. - Endophthalmitis after penetrating keratoplasty. Am. J. Ophthalmol. 95: 651-658, 1983.
⁹
HYNDIUK, R.A.; SKORICH, D.N.; BURDIE. E.M. - Bacteria keratitis. In: TABBARA, K.F. & HYNDIUK, R.A. - Infections of the eye. Boston, Little-Brown, 1986, p.323.
¹⁰
INSLER, M.S.; CAVANAGH. H.D.; WILSON, L.A. - Gentamicin resistant Pseudomonas endophthalmitis after penetrating keratoplasty. Br. J. Ophthalmol. 69: 189-191, 1985.
¹¹
INSLER, M.S. & URSO, L.F. - Candidaalbicans endophthalmitis after penetrating keratoplasty. Am. J. Ophthalmol. 104: 57-60, 1987.
¹²
KARA JOSÉ, N.; MALTA, F.S.; NAKASHIMA, Y. - Ulcera de córnea perfurada e endoftalmite por Staphylococcus epidermidis (albus) após ceratoplastia parcial penetrante combinada com vitrectomia anterior. Arq. Bras. Oftalmol. 40: 426-429, 1977.
¹³
KHODADOUST, A.A. & FRANKLIN, R.M. - Transfer of bacterial infection by donor cornea in penetrating keratoplasty. Am. J. Ophthalmol. 87: 130-132, 1979.
¹⁴
LASS, J.H.; HAAF, J.; FOSTER, C.S.; BELCHER, C. - Visual outcome in eight cases of Serratia marcescens keratitis. Am. J. Ophthalmol. 92: 384-390, 1981.
¹⁵
LEVEILLE, A.S.; McMULLAN, F.D.; CAVANAGH, D.W. - Endophthalmitis following penetrating keratoplasty. Ophthalmology, 90: 38-39, 1983.
¹⁶
O'DAY, D.M. - Diseases potencially transmitted through corneal transplantation. Ophthamology, 96: 1133-1137, 1989.
¹⁷
PARDOS, G.L. & GALLAGHER, R.N. - Microbial contamination of donor eyes: a retrospective study. Arch. Ophthalmol. 100: 1611-1613, 1982.
¹⁸
PEPOSE, J.S. - Transfer of infection via corneal transplantation. Transplant. Proc. 21: 3130-3132, 1989.
¹⁹
POOLE, T.G. & INSLER, M.S. - Contamination of donor cornea by gentamicin resistant organisms. Am. J. Ophthalmol. 97: 560-564, 1984.
²⁰
ROTKIS, W.M. - Postoperative considerations: Infections. In: BRIGHTBILL, F.S. - Corneal surgery: theory, technique and tissue. St Louis, C.V. Mosby, 1986. p.323-325.
²¹
WILSON, S.E. & BOURNE, W.M. - Corneal preservation. Surv. Ophthalmol. 33: 237-259, 1989.
²²
YAU, C.W.; BUSIN, M.; AVNI, J.; KAUFMAN, H.E. - Antibacterial effect of donor corneas stored in gentamicin enriched McCarey-Kaufman medium. Arch. Ophthalmol. 104: 263-265, 1986.
²³
YAU, C.W.; BUSIN, M.; KAUFMAN, H.E. - Ocular concentration of gentamicin after penetranting keroplasty. Am. J. Ophthalmol. 101: 44-48, 1986.

Datas de Publicação

Publicação nesta coleção
Nov-Dec 1991

Este é um artigo publicado em acesso aberto (Open Access) sob a licença Creative Commons Attribution, que permite uso, distribuição e reprodução em qualquer meio, sem restrições desde que o trabalho original seja corretamente citado.

[1] ¹
BAER, J.C.; NIRANKW, V.S.; GLAROS, D.S. - Streptococcal endophthalmitis from contamined donor corneas after keratoplasty. Arch. Ophthalmol. 106: 517-520, 1988.

[2] ²
BECHARA, S.J.; CASTANHEIRA, V.R.C.; BONATTI, J.A.; KARA JOSÉ, N.; MYUNG, J.R; NEMER, R.S. - Incidência e profilaxia de endoftalmites em transplantes de córnea. Rev. Bras. Oftalmol. 46: 23-27, 1987.

[3] ³
BRINSER, J.H. - Ocular bacteriology. In: TABBARA, K.F. & HYNDIUK, R.A. - Infections of the eye. Boston, Little-Brown, 1986. p. 135.

[4] ⁴
CHITIUM, M.E.; GUTZMARKER, R.D.; OILAND, D.M.; KALINA, E. - Contamination of corneal tissue from infected donors. Arch. Ophthalmol. 103: 802-804, 1985.

[5] ⁵
CHRISTENSON, J.; KASTIL, P.R.; CALDWELL, D.R. - Bacterial contamination of donor corneas stored in McCarey-Kaufman medium. Ophthalmic Surg. 13: 231-233, 1982.

[6] ⁶
FONG, L.P.; OMEROD, L.D.; KENION, K.R; FOSTER, C.J. - Microbial keratitis complicating penetrating keratoplasty. Ophthalmology, 95: 1269-1275, 1988.

[7] ⁷
GANDHI, S.S.; LAMBERTS, D.W.; PERRY, H. - Donor to host transmition of disease via corneal transplantation. Surv. Ophthalmol. 25: 306-311, 1981.

[8] ⁸
GUSS, R.B.; KOENIG, S.; PENA, W.; MARX, M.; KAUFMAN, H.E. - Endophthalmitis after penetrating keratoplasty. Am. J. Ophthalmol. 95: 651-658, 1983.

[9] ⁹
HYNDIUK, R.A.; SKORICH, D.N.; BURDIE. E.M. - Bacteria keratitis. In: TABBARA, K.F. & HYNDIUK, R.A. - Infections of the eye. Boston, Little-Brown, 1986, p.323.

[10] ¹⁰
INSLER, M.S.; CAVANAGH. H.D.; WILSON, L.A. - Gentamicin resistant Pseudomonas endophthalmitis after penetrating keratoplasty. Br. J. Ophthalmol. 69: 189-191, 1985.

[11] ¹¹
INSLER, M.S. & URSO, L.F. - Candidaalbicans endophthalmitis after penetrating keratoplasty. Am. J. Ophthalmol. 104: 57-60, 1987.

[12] ¹²
KARA JOSÉ, N.; MALTA, F.S.; NAKASHIMA, Y. - Ulcera de córnea perfurada e endoftalmite por Staphylococcus epidermidis (albus) após ceratoplastia parcial penetrante combinada com vitrectomia anterior. Arq. Bras. Oftalmol. 40: 426-429, 1977.

[13] ¹³
KHODADOUST, A.A. & FRANKLIN, R.M. - Transfer of bacterial infection by donor cornea in penetrating keratoplasty. Am. J. Ophthalmol. 87: 130-132, 1979.

[14] ¹⁴
LASS, J.H.; HAAF, J.; FOSTER, C.S.; BELCHER, C. - Visual outcome in eight cases of Serratia marcescens keratitis. Am. J. Ophthalmol. 92: 384-390, 1981.

[15] ¹⁵
LEVEILLE, A.S.; McMULLAN, F.D.; CAVANAGH, D.W. - Endophthalmitis following penetrating keratoplasty. Ophthalmology, 90: 38-39, 1983.

[16] ¹⁶
O'DAY, D.M. - Diseases potencially transmitted through corneal transplantation. Ophthamology, 96: 1133-1137, 1989.

[17] ¹⁷
PARDOS, G.L. & GALLAGHER, R.N. - Microbial contamination of donor eyes: a retrospective study. Arch. Ophthalmol. 100: 1611-1613, 1982.

[18] ¹⁸
PEPOSE, J.S. - Transfer of infection via corneal transplantation. Transplant. Proc. 21: 3130-3132, 1989.

[19] ¹⁹
POOLE, T.G. & INSLER, M.S. - Contamination of donor cornea by gentamicin resistant organisms. Am. J. Ophthalmol. 97: 560-564, 1984.

[20] ²⁰
ROTKIS, W.M. - Postoperative considerations: Infections. In: BRIGHTBILL, F.S. - Corneal surgery: theory, technique and tissue. St Louis, C.V. Mosby, 1986. p.323-325.

[21] ²¹
WILSON, S.E. & BOURNE, W.M. - Corneal preservation. Surv. Ophthalmol. 33: 237-259, 1989.

[22] ²²
YAU, C.W.; BUSIN, M.; AVNI, J.; KAUFMAN, H.E. - Antibacterial effect of donor corneas stored in gentamicin enriched McCarey-Kaufman medium. Arch. Ophthalmol. 104: 263-265, 1986.

[23] ²³
YAU, C.W.; BUSIN, M.; KAUFMAN, H.E. - Ocular concentration of gentamicin after penetranting keroplasty. Am. J. Ophthalmol. 101: 44-48, 1986.

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