Amniotic membrane transplantation in a patient with impending perforated corneal ulcer caused by Streptococcus mitis: A case report and review of literature

BACKGROUND Streptococcus mitis(S.mitis)is an opportunistic pathogen that can lead to severe ocular infections.In previous reports,penetrating keratoplasty(PK)was usually adopted for the treatment of persistent corneal ulcers.This report describes an unusual case of nonhealing descemetocele caused by S.mitis treated by antibiotics plus amniotic membrane transplantation(AMT).CASE SUMMARY A 63-year-old woman presented with a right persistent corneal ulcer that she had suffered from for the past 9 mo.The culture of a corneal scraping yielded S.mitis.The right eye descemetocele decreased in diameter from 3 to 0.8 mm after the continuous administration of topical vancomycin and ceftriaxone for 2 wk.Due to the slow healing,AMT was performed.Her corneal erosion healed and gradually became clear.Her visual acuity recovered from initially counting fingers to 100/200 at the last follow-up,67 mo after AMT.CONCLUSION Antibiotics plus AMT may be an effective alternative treatment other than PK to promote epithelializationand to reduce inflammation in the corneas complicated by S. mitis keratitis.

Antimicrobial Activity of Traditional Chinese Medicines on Common Oral Bacteria

Objective: To evaluate twenty Traditional Chinese Medicines (TCM) against four oral bacteria. Methods: Twenty TCM were tested for sensitivity against Streptococcus mitis, Streptococcus sanguis, Streptococcus mutans and Porphyromonas gingivalis. Aliquots of suspension of each bacterial species were inoculated on a horse blood agar (HBA) plate, 6 mm diameter paper disks was soaked in different drug suspensions were placed concentrically on a HBA plate. Disks soaked in 0.2% w/v chlorhexidine were used as positive controls. These HBA plates were incubated for 48 hours anaerobically and the diameters of growth inhibition of three different areas were measured using a calibrated computer software and the mean diameter obtained for each bacteria. Broth microdilution assay was used to determine minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). The experiment was repeated on three separate occasions. Results: The TCMs that consistently against Porphyromonas gingivalis, included Folium artemisiae argyi, Fructus crataegi, Rhizoma dryopteris crassirhizomae, Flos magnoliae, Rhizoma polygoni cuspidati, Radix scrophulariae ningpoensis, Galla chinensis, Radix scutellariae baicalensis and Rhizoma coptidis;against Streptococcus mutans included Fructus crataegi, Galla chinensis and Rhizoma copitidis;against Streptococcus mitis and Streptococcus sanguis included Galla chinensis and Rhizoma copitidis. Conclusion: Rhizoma copitidis and Galla chinensis had inhibitory effects on Streptococcus mitis, Streptococcus sanguis, Streptococcus mutans and Porphyromonas gingivalis in vitro.