How a Diligent Doctor Slayed the Swamp Monster!

When Shraddha Sharma, a worried 34 year old mother of two little children came to the emergency clinic on the 8 April 2016 for the treatment of a corneal infection, she had already been told that her eye will need to be removed due to a severe infection. She had been on treatment of this condition for 2 months and had undergone a therapeutic corneal transplant to get rid of the infection a fortnight ago in Indore.

However the infection just refused to go away and had recurred with renewed vigour in the new graft too. When we saw her, she had a a total corneal infection that had even begun to spread to the white part of the eye - the sclera.

Diagnostics done at the microbiology lab revealed that she had an infection with a deadly organism called Pythium insidiosum and we knew we were in for a battle as all previous patients with a recurrent infection with this organism, also called the “Swamp Monster” had lost their eye.

Till recently this organism, which causes infection in horses was treated as a fungus and with traditional therapy. This was when Alisha Desai, a young Cornea fellow decided to spend a night researching this organism and stumbled upon literature from veterinary science that provided a clue! Pythium, traditionally treated as a fungus was not actually a fungus but a primitive organism called a prokaryote and was susceptible to non mainstream drugs like linezolid and azithromycin, which nobody in Ophthalmology, anywhere in the world had thought of before!

Though there were no reports of these drugs being used for this infection in human eyes, we decided to bite the bullet and along with Jay Chhablani, our retina colleague, operated on the eye for a second repeat transplant and injected the new drugs repeatedly in the eye. Our hypothesis was supported fully by Dr Savitri Sharma, our senior microbiologist, who provided laboratory proof of our new drugs working.

Though we kept our fingers crossed, magically Shraddha started to respond and three months after the ordeal made a dramatic recovery and is now completely free of the deadly infection. She has a very good vision now and can finally concentrate on what is really important for her…her children!