Logo American Journal of Case Reports

Call: 1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Contact Us

Logo American Journal of Case Reports Logo American Journal of Case Reports Logo American Journal of Case Reports

27 November 2014 : Case report  USA

Rheumatoid Arthritis-Associated Corneal Ulceration with Superimposed Infection by Methicillin-Resistant Staphylococcus aureus: A Complicated Type of Corneal Melt

Unusual clinical course, Challenging differential diagnosis

Gurpinder SinghBEF, Vincent Bryan SalvadorBEF, Arindam BagchiBF, Racheal TushabeBF, Adriana AbrudescuBEF

DOI: 10.12659/AJCR.891127

Am J Case Rep 2014; 15:523-525

Abstract

BACKGROUND: Severe extra-articular manifestations of rheumatoid arthritis usually occur in advanced stages of the disease. In particular, ocular involvement may lead to inflammatory corneal ulceration, in which therapy is challenging owing to its association with systemic vasculitis. Close collaboration between ophthalmologists and rheumatologists is paramount in providing the best treatment approach in this sight-threatening condition.

CASE REPORT: We present a case of seropositive rheumatoid arthritis associated with corneal melting in the absence of other typical clinical manifestations of rheumatoid arthritis flare. The rheumatoid arthritis-associated corneal ulcer was complicated in our case by concomitant infection with methicillin-resistant Staphylococcus aureus, which was treated with intravenous vancomycin after an initial antimicrobial ophthalmic solution proved not to be making adequate improvement in the corneal healing. The recurrent corneal melting appeared to be aggravated by the ophthalmic infection while on immunosuppressive regimen.

CONCLUSIONS: In patients on biologic agents, intravenous antibiotics must be considered in addition to ophthalmic eye solution in controlling the infectious process. Excluding concomitant ophthalmic infection is equally important before initiation of high-dose steroid and immunosuppressive regimens.

Keywords: Arthritis, Rheumatoid - complications, Cornea - pathology, Corneal Ulcer - microbiology, Diagnosis, Differential, Eye Infections, Bacterial - microbiology, Methicillin-Resistant Staphylococcus aureus - isolation & purification, Staphylococcal Infections - microbiology

Add Comment 0 Comments

In Press

Case report  Indonesia

Diagnostic Challenges in Acute Fatty Liver of Pregnancy: Fever as a Key Symptom in Case Series from Indonesia

Am J Case Rep In Press; DOI: 10.12659/AJCR.946614  

0:00

Case report  Ecuador

Middle-Lobe Bronchus Transection in Blunt Thoracic Trauma From a High-Speed Motor Vehicle Collision: A Case...

Am J Case Rep In Press; DOI: 10.12659/AJCR.946488  

0:00

Case report  Saudi Arabia

Innovative Callus Release Technique for Closed Reduction in Old Fractures: Case Studies and Methodology

Am J Case Rep In Press; DOI: 10.12659/AJCR.946876  

0:00

Case report  Malaysia

Asymptomatic Postpartum Bradycardia: A Case of Spontaneous Resolution in a 34-Year-Old Woman

Am J Case Rep In Press; DOI: 10.12659/AJCR.946560  

0:00

Most Viewed Current Articles

21 Jun 2024 : Case report  China (mainland) 96,182

Intracranial Parasitic Fetus in a Living Infant: A Case Study with Surgical Intervention and Prognosis Anal...

DOI :10.12659/AJCR.944371

Am J Case Rep 2024; 25:e944371

0:00

07 Mar 2024 : Case report  USA 52,159

Neurocysticercosis Presenting as Migraine in the United States

DOI :10.12659/AJCR.943133

Am J Case Rep 2024; 25:e943133

0:00

20 Nov 2023 : Case report  Saudi Arabia 31,026

Azithromycin Treatment for Acne Vulgaris: A Case Report on the Risk of Clostridioides difficile Infection

DOI :10.12659/AJCR.941424

Am J Case Rep 2023; 24:e941424

0:00

18 Feb 2024 : Case report  Japan 23,365

A Case of Thoracic Empyema Caused by Actinomyces naeslundii

DOI :10.12659/AJCR.943030

Am J Case Rep 2024; 25:e943030

0:00

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923