1887

Abstract

Introduction:

species are rare keratitis‐causing pathogens. We herein report a case of keratitis caused by a drug‐resistant species in association with contact lenses.

Case presentation:

A 64‐year‐old female who wore a contact lens in her right eye to facilitate repair of the corneal epithelium complained of infection and discharge. Slit‐lamp biomicroscopy showed corneal abscessation and hypopyon. Thus, infectious keratitis was diagnosed. Direct microscopy and bacterial culture of a corneal scraping were performed. Because direct microscopy demonstrated the presence of Gram‐negative rods, we began treatment with topical 1.5 % levofloxacin and 0.3 % tobramycin every hour. The corneal infiltration increased 4 days after initiating the therapy. The culture report confirmed the presence of a species with fluoroquinolone and aminoglycoside resistance and susceptibility to cephalosporins and minocycline. We switched to topical 0.5 % cefmenoxime every hour and oral minocycline at 200 mg day. The corneal inflammation subsided within 2 weeks. The bacterial isolate was identified as using 16S rRNA sequencing.

Conclusions:

We encountered a case of keratitis caused by with reduced fluoroquinolone and aminoglycoside susceptibility.

Loading

Article metrics loading...

/content/journal/jmmcr/10.1099/jmmcr.0.000004
2015-02-01
2019-11-21
Loading full text...

Full text loading...

/deliver/fulltext/jmmcr/2/1/jmmcr000004.html?itemId=/content/journal/jmmcr/10.1099/jmmcr.0.000004&mimeType=html&fmt=ahah

References

  1. Alexandrakis G., Palma L.A., Miller D., Alfonso E.C.. ( 2000;). Capnocytophaga keratitis. Ophthalmology107:1503–1506[CrossRef]
    [Google Scholar]
  2. Bremmelgaard A., Pers C., Kristiansen J.E., Korner B., Heltberg O., Frederiksen W.. ( 1989;). Susceptibility testing of Danish isolates of Capnocytophaga and CDC group DF‐2 bacteria. Acta Pathol Microbiol Immunol Scand97:43–48[CrossRef]
    [Google Scholar]
  3. Burns R.P.. ( 1969;). Pseudomonas aeruginosa keratitis: mixed infections of the eye. Am J Ophthalmol67:257–262[CrossRef]
    [Google Scholar]
  4. Chodosh J.. ( 2001;). Cat's tooth keratitis: human corneal infection with Capnocytophaga canimorsus . Cornea20:661–663[CrossRef]
    [Google Scholar]
  5. Font R.L., Jay V., Misra R.P., Jones D.B., Wilhelmus K.R.. ( 1994;). Capnocytophaga keratitis. A clinicopathologic study of three patients, including electron microscopic observations. Ophthalmology101:1929–1934[CrossRef]
    [Google Scholar]
  6. Gilbert M.L., Wilhelmus K.R., Osato M.S.. ( 1987;). Comparative bioavailability and efficacy of fortified topical tobramycin. Invest Ophthalmol Visual Sci28:881–885
    [Google Scholar]
  7. Gomez‐Garces J.L., Alos J.I., Sanchez J., Cogollos R.. ( 1994;). Bacteremia by multidrug‐resistant Capnocytophaga sputigena . J Clin Microbiol32:1067–1069
    [Google Scholar]
  8. Hawkey P.M., Smith S.D., Haynes J., Malnick H., Forlenza S.W.. ( 1987;). In vitro susceptibility of Capnocytophaga species to antimicrobial agents. Antimicrob Agents Chemother31:331–332[CrossRef]
    [Google Scholar]
  9. Heidemann D.G., Pflugfelder S.C., Kronish J., Alfonso E.C., Dunn S.P., Ullman S.. ( 1988;). Necrotizing keratitis caused by Capnocytophaga ochracea . Am J Ophthalmol105:655–660[CrossRef]
    [Google Scholar]
  10. Jolivet‐Gougeon A., Sixou J.L., Tamanai‐Shacoori Z., Bonnaure‐Mallet M.. ( 2007;). Antimicrobial treatment of Capnocytophaga infections. Int JAntimicrob Agents29:367–373[CrossRef]
    [Google Scholar]
  11. Kowalski R.P., Kowalski T.A., Shanks R.M., Romanowski E.G., Karenchak L.M., Mah F.S.. ( 2013;). In vitro comparison of combination and monotherapy for the empiric and optimal coverage of bacterial keratitis based on incidence of infection. Cornea32:830–834[CrossRef]
    [Google Scholar]
  12. Lee H., Min K., Kim E.K., Kim T.I.. ( 2012;). Minocycline controls clinical outcomes and inflammatory cytokines in moderate and severe meibomian gland dysfunction. Am J Ophthalmol 154,949–957:e941
    [Google Scholar]
  13. Loh R.S., Chan C.M., Ti S.E., Lim L., Chan K.S., Tan D.T.. ( 2009;). Emerging prevalence of microsporidial keratitis in Singapore: epidemiology, clinical features, and management. Ophthalmology116:2348–2353[CrossRef]
    [Google Scholar]
  14. Ly C.N., Pham J.N., Badenoch P.R., Bell S.M., Hawkins G., Rafferty D.L., McClellan K.A.. ( 2006;). Bacteria commonly isolated from keratitis specimens retain antibiotic susceptibility to fluoroquinolones and gentamicin plus cephalothin. Clin Exp Ophthalmol34:44–50[CrossRef]
    [Google Scholar]
  15. Pamel G.J., Buckley D.J., Frucht J., Krausz H., Feldman S.T.. ( 1989;). Capnocytophaga keratitis. Am J Ophthalmol107:193–194[CrossRef]
    [Google Scholar]
  16. Roscoe D.L., Zemcov S.J., Thornber D., Wise R., Clarke A.M.. ( 1992;). Antimicrobial susceptibilities and beta‐lactamase characterization of Capnocytophaga species. Antimicrob Agents Chemother36:2197–2200[CrossRef]
    [Google Scholar]
  17. Roussel T.J., Osato M.S., Wilhelmus K.R.. ( 1985;). Capnocytophaga keratitis. Br J Ophthalmol69:187–188[CrossRef]
    [Google Scholar]
  18. Rummens J.L., Gordts B., Van Landuyt H.W.. ( 1986;). In vitro susceptibility of Capnocytophaga species to 29 antimicrobial agents. Antimicrob Agents Chemother30:739–742[CrossRef]
    [Google Scholar]
  19. Suzuki T., Ohashi Y.. ( 2013;). Combination effect of antibiotics against bacteria isolated from keratitis using fractional inhibitory concentration index. Cornea32:e156–e160[CrossRef]
    [Google Scholar]
  20. Tabbara K.F., Cooper H.. ( 1989;). Minocycline levels in tears of patients with active trachoma. Arch Ophthalmol107:93–95[CrossRef]
    [Google Scholar]
  21. Ticho B.H., Urban R.C. Jr, Safran M.J., Saggau D.D.. ( 1990;). Capnocytophaga keratitis associated with poor dentition and human immunodeficiency virus infection. Am J Ophthalmol109:352–353[CrossRef]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmmcr/10.1099/jmmcr.0.000004
Loading
/content/journal/jmmcr/10.1099/jmmcr.0.000004
Loading

Data & Media loading...

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error