Successful management of pediatric Pythium insidiosum keratitis - A case report highlighting the role of targeted antimicrobial therapy and mechanical debridement
Abstract
Human pythiosis keratitis is a rare but potentially sight-threatening infection. We report the case of an 8-year-old boy who developed a nonhealing corneal ulcer after finger nail trauma that did not respond to broad-spectrum antibiotics. Initial cultures identified Staphylococcus warneri and Streptococcus mitis. Worsening clinical signs prompted repeat investigations, which confirmed Pythium insidiosum through polymerase chain reaction. Despite intensive topical (natamycin and voriconazole) and systemic antifungals (voriconazole), the ulcer progressed with biofilm formation. Manual debridement and a revised regimen of topical linezolid 0.2% alternating with topical ceftazidime 5% led to significant clinical improvement. After 8 weeks of topical therapy and regular debridement, the infection eventually resolved with a paracentral scar and unaided visual acuity of 6/6. This case highlights the diagnostic complexity of Pythium keratitis and the crucial role of early microbial identification in pediatric ocular trauma. We attribute the successful management in this case to prompt diagnostic reevaluation, targeted antimicrobial therapy, and repeated scraping of ulcer biofilm.
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Synthesis, In Vitro and In Silico Molecular Docking Studies of Novel Phthalimide–Pyrimidine Hybrid Analogues to Thalidomide as Potent Antitubercular Agents
- Exploring the inhibitory performance of expired moxifloxacin and norfloxacin on copper corrosion in saline environment
- Molecular investigation of antimicrobial peptides against Helicobacter pylori proteins using a peptide-protein docking approach
- Screening of novel narrow-spectrum benzofuroxan derivatives for the treatment of multidrug-resistant tuberculosis through in silico, in vitro, and in vivo approaches
- Synthesis, Characterization, Anticancer, Antioxidant, and In Silico Evaluation of Semicarbazides and Thiosemicarbazides
- Fast and accurate prediction of drug induced proarrhythmic risk with sex specific cardiac emulators
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.