Clinical diagnosis and treatment of rare painless keratitis caused bythree pathogens: clinical practice and experiential discussion

摘要

There have been numerous reports regarding the occurrence of keratitis inpatients with soft contact lenses, but few reports in patients with rigid gaspermeable contact lenses. To the best of our knowledge, the occurrence ofinfection associated with three species of pathogens has never been reported.Here, we describe a patient who exhibited refractory painless keratitis causedby three pathogens ( , , and herpes simplex virus) and summarizesimilar reports published at multiple centers worldwide, with the aim ofproviding guidance for clinicians who might encounter mixed-type cornealinfections. We describe the results of many ophthalmologic and laboratoryinvestigations, which guided our treatment selection. We achieved good treatmentefficacy, such that the patient exhibited a corrected visual acuity of 20/20 inthe affected eye after a series of treatments, including curettage of ulcerlesions. Corneal infections caused by multiple pathogens are challenging inclinical practice. This summary of our experience in patient diagnosis andtreatment can help clinicians to achieve a favorable prognosis in treatment offuture patients.