Priyadarshini Smruti Rekha, Behera Himanshu Sekhara, Sahu Srikant, Dutta Anirban
Cornea and Anterior Segment Services, LV Prasad Eye Institute, Mithu Tulsi Chanrai Campus, Bhubaneswar, Orissa, India.
Ocular Microbiology Service, L. V. Prasad Eye Institute, Mithu Tulsi Chanrai Campus, Bhubaneswar, Orissa, India
BMJ Case Rep. 2021 Jul 1;14(7):e241371. doi: 10.1136/bcr-2020-241371.
A 10-year-old boy treated for alkali injury with multiple interventions presented with a perforated corneal ulcer with clinically suspected bacterial aetiology. Cornea scraping and tissue adhesive application were planned. During surgery, an eyelash was found embedded at the perforated site. Gram staining of corneal scraping revealed the presence of Gram-positive bacilli on the first day which later was identified as with culture followed by VITEK V.2.0 (Biomerieux) identification. The bacterium was found to be sensitive to amikacin, ciprofloxacin, cefazolin, gatifloxacin, moxifloxacin, ofloxacin and vancomycin antibiotics as per Clinical and Laboratory Standards Institute guidelines. Coryneform bacteria is a rare cause of keratitis, and this is the first reported case of microbial keratitis caused by one of the rare corynebacterium species to the best of our knowledge. Literature search does not reveal any specific ocular features typical to this organism. This case supports the growing evidence for pathogenicity of in ocular samples. This study demonstrates the utility of VITEK for the identification of rare pathogen and may facilitate the use of certain antibiotics in the treatment regimen of infections.
一名10岁男孩因碱烧伤接受了多次干预治疗,现出现角膜溃疡穿孔,临床怀疑为细菌感染病因。计划进行角膜刮片和应用组织粘合剂。手术过程中,发现穿孔部位嵌有一根睫毛。角膜刮片的革兰氏染色显示第一天存在革兰氏阳性杆菌,随后通过培养鉴定,再用VITEK V.2.0(生物梅里埃公司)进行识别。根据临床和实验室标准协会指南,发现该细菌对阿米卡星、环丙沙星、头孢唑林、加替沙星、莫西沙星、氧氟沙星和万古霉素敏感。棒状杆菌是角膜炎的罕见病因,据我们所知,这是首例由罕见棒状杆菌属之一引起的微生物性角膜炎报告病例。文献检索未发现该病原体典型的任何特定眼部特征。该病例支持了眼部样本中该病原体致病性的证据不断增加。本研究证明了VITEK在鉴定罕见病原体方面的实用性,并可能有助于在该病原体感染的治疗方案中使用某些抗生素。