DR. KAVYA CHANDRAN

DR. PAAVAN KALRA

Abstract

A 26 year old gentleman presented with episodes of redness and watering in his left eye since 8 months and was treated elsewhere with topical steroids and antivirals.A leash of angry looking deep stromal vascularisation across the cornea was noted with an adjacent crescentric white infiltrate. On strong clinical suspicion a diagnosis of HSV Stromal keratitis was made and continued on topical steroids and oral antivirals.At 1 month,the clinical picture was status quo.In view of the atypical indolent course and non response repeat scraping was done.Acid fast staining with 20% H2SO4 revealed slender long beaded non branching AFB suggestive of mycobacteria.The species was identified as Mycobacterium Abcessus by MALDI TOF( Matrix Assisted Laser Desorption Ionization Time of Flight).He responded well to fortified amikacin. We wish to highlight the unusual presentation and course of mycobacterium keratitis and the role of newer diagnostic methods ( MALDI TOF ) for species identification.