Background Pseudomaonas aeruginosa may account for 8% of acquired Ophtalmia Neonatorum in modern NICUs. Under recognition may lead to delays in treatment.
Objective To highlight the presentation and severity of P. aeruginosa ocular infection in preterm infants and describe the early medical management and evaluation.
Case Reports: We report two cases of invasive P.aeruginosa eye infections treated on level III units in the SE London Perinatal Network.
Case 1: 31 weeks GA infant developed purulent discharge from one eye on day 4. The cornea became opaque (day 6) with periorbital swelling on treatment (Clarithromycin drops IV ceftazidime, gentamicin). Eye swabs (d5): P.aeruginosa. Subsequently treated with Ofaxocillin eye drops. The cornea became necrotic and the infant received an amniotic membrane graft. (Figure 1 and 2).
Case 2: 33 week GA with swelling and erythema of the eyelid in 1 eye (day 4) with 2 white lesions on the cornea. Within 24 h the sclera appeared yellow with pustular discharge. There was corneal ulceration and hypopyon. Corneal scrapings and eye swaps grew P.aeruginosa. Blood cultures were negative. The central corneal ulceration was repaired with conjunctival flap. A temporal tarsorrhaphy was placed from d17–28 Subsequently required an amniotic membrane graft.
Conclusion P. Aeruginosa ON in preterm can lead to rapid severe ocular infection. Increased vigilance and rapid microbiological evaluation of sticky eyes is required. Urgent ophthalmological examination and prompt treatment may ameliorate visual impairment.