Fulminant bilateral Haemophilus influenzae keratitis in a patient with hypovitaminosis A treated with contaminated autologous serum

Abstract

Empar Sanz-Marco1, Manuel Diaz-Llopis1–3, Maria J Lopez-Prats1, Salvador Garcia-Delpech1,4, Patricia Udaondo11Ophthalmology, La Fe University Hospital of Valencia, Valencia, Spain; 2Faculty of Medicine, University of Valencia, Valencia, Spain; 3Biomedical Research Center for Rare Diseases Network (CIBERER), Valencia, Spain; 4Faculty of Medicine, Catholic University of Valencia, Valencia, SpainAbstract: We report on a patient with hypovitaminosis A treated with autologous serum (AS) who had bilateral infectious ulcers positive for Haemophilus influenzae. The patient suffered a perforation of his right eye and total healing of his left eye with a residual leukoma. In cases of severe malnutrition, serum levels of vitamins and bacteriostatic and growth factors are reduced, so AS would not only be ineffective but also increase the risk of secondary corneal infection. The prophylactic use of a topical antibiotic would be useful in treatment with AS, especially in patients who do not use and adequately store the eye drops, as in our patient.Keywords: Haemophilus influenzae, hypovitaminosis A, bilateral infectious ulcers