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LETTER TO EDITOR
Year : 2020  |  Volume : 8  |  Issue : 1  |  Page : 46

Infective scleral abscess by Proteus mirabilis in an immunocompetent patient


Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq

Date of Web Publication6-Mar-2020

Correspondence Address:
Mahmood Dhahir Al-Mendalawi
Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, P.O. Box: 55302, Baghdad Post Office, Baghdad
Iraq
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jcor.jcor_85_18

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How to cite this article:
Al-Mendalawi MD. Infective scleral abscess by Proteus mirabilis in an immunocompetent patient. J Clin Ophthalmol Res 2020;8:46

How to cite this URL:
Al-Mendalawi MD. Infective scleral abscess by Proteus mirabilis in an immunocompetent patient. J Clin Ophthalmol Res [serial online] 2020 [cited 2020 Apr 1];8:46. Available from: http://www.jcor.in/text.asp?2020/8/1/46/280215



Sir,

I read with interest the case report by Das and Das[1] on the infective scleral abscess (SA) by Proteus mirabilis in an Indian patient. The authors nicely described the clinical presentation as well as the diagnostic and therapeutic measures in the studied patient. The authors firmly concluded that the studied patient was immunocompetent based on their notion that “he had no history of trauma, surgery, ocular ailments, or any other infective foci including urinary tract infection or history of intravenous drug addiction. He had a mild fatty liver as a systemic illness. His blood reports and serology profile were normal.”[1] Despite that notion, I still assume that the rarity of the condition should trigger the need to consider jeopardized immune status in the studied patient. Among jeopardized immune states, infection with human immunodeficiency virus (HIV) is paramount. It is explicit that compared to immunocompetent individuals, HIV-infected individuals are more vulnerable to different ocular infections that are associated with a high ocular morbidity and mortality rate.[2] Among these ocular infections, fungal SA in HIV-positive patients has been reported.[3] To my knowledge, HIV epidemic is maturing in India. The available data pointed out to 0.26% HIV seroprevalence compared with a global average of 0.2%.[4] I presume that the authors did not specifically consider underlying HIV infection in the studied patient. Hence, contemplating the diagnostic panel of blood CD4 lymphocyte count and viral overload measurements was envisaged in the studied patient. If that panel was done and it showed HIV reactivity, the case in question could be surely considered a novel case report of HIV-associated bacterial SA. This is because HIV-positive patients have been reported in the world literature to develop fungal SA only.[3]

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Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Das N, Das J. Infective scleral abscess by Proteus mirabilis in an immunocompetent patient. J Clin Ophthalmol Res 2018;6:113-6.  Back to cited text no. 1
  [Full text]  
2.
Kronish JW, Johnson TE, Gilberg SM, Corrent GF, McLeish WM, Scott KR. Orbital infections in patients with human immunodeficiency virus infection. Ophthalmology 1996;103:1483-92.  Back to cited text no. 2
    
3.
Sharma H, Sudharshan S, Therese L, Agarwal M, Biswas J. Candida albicans scleral abscess in a HIV-positive patient and its successful resolution with antifungal therapy-a first case report. J Ophthalmic Inflamm Infect 2016;6:24.  Back to cited text no. 3
    
4.
Paranjape RS, Challacombe SJ. HIV/AIDS in India: An overview of the Indian epidemic. Oral Dis 2016;22 Suppl 1:10-4.  Back to cited text no. 4
    




 

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