A case of bilateral keratitis caused by Providencia alcalifaciens: a rarely encountered ocular pathogen.

PURPOSE

To report a case of keratitis caused by Providencia alcalifaciens.

METHODS

A 70-year-old man presented with pain, redness, and decreased vision in both of his eyes. On initial presentation, the visual acuity in both of his eyes was hand motion, and slit lamp examination showed diffuse infiltrates and total epithelial defects of the cornea, conjunctival hyperemia, and severe anterior chamber reactions with 2-mm-height hypopyon. The results of laboratory studies revealed elevated liver function tests, which indicated the presence of alcoholic liver disease.

RESULTS

The culture result was positive for P. alcalifaciens and showed sensitivity to ceftazidime and amikacin but resistant to cefazolin, gentamicin, fluoroquinolone, and ampicillin. He was treated with topical application and intravenous injection of ceftazidime. His keratitis resolved gradually over 3 months as the treatment dose was tapered and the treatment was eventually discontinued. His final visual acuity was 20/200 in the right eye and 20/60 in the left eye because of the remaining central corneal opacity.

CONCLUSIONS

We report a first case of keratitis due to P. alcalifaciens in a chronic heavy alcohol drinker. Ophthalmologists should consider this bacterium as a potential pathogen of corneal ulceration, when clinically suspect gram-negative bacterial keratitis especially in immunocompromised state.