Cornea and External Eye Department, Moorfields Eye Hospital NHS Foundation Trust, St George's Hospital, London, United Kingdom.
Cornea. 2021 Aug 1;40(8):1062-1064. doi: 10.1097/ICO.0000000000002584.
To report the first case of Paenibacillus glucanolyticus, a spore-forming bacteria, to be isolated in a human ocular infection.
We describe a severe case of noncontact lens-related microbial keratitis due to P. glucanolyticus presenting with a large corneal abscess, severe ocular inflammation, and a large epithelial defect.
The corneal scrapes with no growth initially cultured P. glucanolyticus on blood agar after 48 hours, with sensitivity to gentamicin and fluoroquinolones. No other organism was cultured. The patient had severe keratitis with a protracted course requiring cyanoacrylate glue patching because of keratolysis and perforation. The patient may benefit from a penetrating keratoplasty and extracapsular cataract extraction in due course to aid visual rehabilitation.
This is the first reported ocular case of P. glucanolyticus demonstrating its bacterial virulence and pathogenic potential when infecting the cornea. Rapid identification with newer technology enable us to accurately identify these opportunistic bacteria and may give a more favorable visual outcome as correct sensitivities lead to timely treatment administration.
报告首例人体眼感染解淀粉芽胞杆菌的病例。
我们描述了一例因解淀粉芽胞杆菌引起的严重非接触镜相关微生物角膜炎病例,该病例表现为大角膜脓肿、严重眼部炎症和大的上皮缺损。
最初角膜刮片在血琼脂上培养 48 小时无生长,培养出解淀粉芽胞杆菌,对庆大霉素和氟喹诺酮类敏感。未培养出其他病原体。患者角膜炎严重,病程迁延,由于角膜溶解和穿孔,需要氰基丙烯酸酯胶贴片。患者将来可能需要穿透性角膜移植术和囊外白内障摘除术,以帮助视力康复。
这是首例报道的解淀粉芽胞杆菌眼部感染病例,表明其在感染角膜时具有细菌毒力和致病潜力。新技术的快速鉴定使我们能够准确识别这些机会性细菌,并可能获得更好的视力结果,因为正确的敏感性导致及时的治疗管理。