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.

  • This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0/).
Loading

Article metrics loading...

/content/journal/jmmcr/10.1099/jmmcr.0.000004
2015-02-01
2024-04-18
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. Ophthalmology 107:1503–1506 [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 Scand 97:43–48 [CrossRef]
    [Google Scholar]
  3. Burns R.P. ( 1969). Pseudomonas aeruginosa keratitis: mixed infections of the eye. Am J Ophthalmol 67:257–262 [CrossRef]
    [Google Scholar]
  4. Chodosh J. ( 2001). Cat's tooth keratitis: human corneal infection with Capnocytophaga canimorsus . Cornea 20:661–663 [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. Ophthalmology 101:1929–1934 [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 Sci 28:881–885
    [Google Scholar]
  7. Gomez‐Garces J.L., Alos J.I., Sanchez J., Cogollos R. ( 1994). Bacteremia by multidrug‐resistant Capnocytophaga sputigena . J Clin Microbiol 32:1067–1069
    [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 Chemother 31:331–332 [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 Ophthalmol 105:655–660 [CrossRef]
    [Google Scholar]
  10. Jolivet‐Gougeon A., Sixou J.L., Tamanai‐Shacoori Z., Bonnaure‐Mallet M. ( 2007). Antimicrobial treatment of Capnocytophaga infections. Int JAntimicrob Agents 29:367–373 [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. Cornea 32:830–834 [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. Ophthalmology 116:2348–2353 [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 Ophthalmol 34:44–50 [CrossRef]
    [Google Scholar]
  15. Pamel G.J., Buckley D.J., Frucht J., Krausz H., Feldman S.T. ( 1989). Capnocytophaga keratitis. Am J Ophthalmol 107:193–194 [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 Chemother 36:2197–2200 [CrossRef]
    [Google Scholar]
  17. Roussel T.J., Osato M.S., Wilhelmus K.R. ( 1985). Capnocytophaga keratitis. Br J Ophthalmol 69:187–188 [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 Chemother 30:739–742 [CrossRef]
    [Google Scholar]
  19. Suzuki T., Ohashi Y. ( 2013). Combination effect of antibiotics against bacteria isolated from keratitis using fractional inhibitory concentration index. Cornea 32:e156–e160 [CrossRef]
    [Google Scholar]
  20. Tabbara K.F., Cooper H. ( 1989). Minocycline levels in tears of patients with active trachoma. Arch Ophthalmol 107:93–95 [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 Ophthalmol 109:352–353 [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...

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