J Korean Med Sci.  2010 Aug;25(8):1251-1252. 10.3346/jkms.2010.25.8.1251.

Corneal Perforation with Preseptal Cellulitis in a Patient with Acute Lymphocytic Leukemia

• Im SK
• Yoon KC

• KMID: 1714055
• DOI: http://doi.org/10.3346/jkms.2010.25.8.1251

Abstract

We report a case of corneal perforation with preseptal cellulitis in a patient with acute lymphocytic leukemia (ALL). A 17-yr-old female patient who was undergoing combination chemotherapy for ALL was referred due to upper lid swelling and pain in the right eye for 2 days. Visual acuity in the right eye was 20/20. Initial examination showed no abnormal findings, other than swelling of the right upper eyelid. Computed tomography showed a finding of preseptal cellulitis. Microbiologic study of bloody and purulent discharge revealed Serratia marcescens. Corneal melting and perforation with iris prolapse were detected in the right eye on the 16th day. Emergent tectonic keratoplasty was performed. Seven months after surgery, visual acuity in the right eye was 20/300, and the corneal graft was stable.

Keyword

Precursor Cell Lymphoblastic Leukemia-Lymphoma; Drug Therapy; Corneal Perforation; Preseptal Cellulitis; Serratia marcescens

MeSH Terms

Adolescent
Anti-Bacterial Agents/therapeutic use
Cellulitis/*diagnosis/drug therapy/etiology/microbiology
Corneal Perforation/*diagnosis/etiology/therapy
Corneal Transplantation
Drug Therapy, Combination
Female
Humans
Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications/*drug therapy
Serratia marcescens/isolation & purification
Tomography, X-Ray Computed
Visual Acuity

Figure

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  Fig. 1 Slit lamp photographs in a 17-yr-old female patient receiving systemic chemotherapy for acute lymphocytic leukemia. (A) Marked congestion and inflammation of the upper tarsal conjunctiva and a melting lesion with sharp demarcation observed in the upper part of the cornea. (B) The iris was prolapsed at the perforated site.

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