To describe a case of multiorganism, drug-resistant keratitis that responded well to corneal crosslinking (CXL) treatment.Methods:
A 52-year-old man presented to our institute with a 2-month ocular history of infectious keratitis in his right eye, on topical antibacterial, antifungal, and antiprotozoan treatment, and complained of increase in pain, discomfort, and visual deterioration. Slit-lamp examination revealed advanced infectious keratitis (extensive deep corneal infiltrate with perineuritis). Cultural and molecular analysis of obtained corneal specimens demonstrated combined fungal and Acanthamoeba infection; confocal microscopy confirmed Acanthamoeba infection. Intense targeted topical antifungal and antiprotozoan treatment was initiated immediately and 1 month later CXL was performed due to drug resistance of the infection.Results:
Two weeks after CXL treatment, the corneal findings had deteriorated, while a corneal abscess was formed and extended at almost half of the cornea. This was gradually limited and the corneal infiltrate and abscess were eventually decreased. In addition, the symptoms improved.Conclusions:
Corneal crosslinking could be an effective therapy in the management of advanced infectious keratitis unresponsive to conventional medical treatment.