Elsheikh Mohammed, Elsayed Ahmed, Bennett Nicholas, Connor Martin
Ophthalmology, NHS Dumfries & Galloway, Dumfries, GBR.
Microbiology, NHS Dumfries & Galloway, Dumfries, GBR.
Cureus. 2021 Aug 5;13(8):e16913. doi: 10.7759/cureus.16913. eCollection 2021 Aug.
We report a rare case of severe, non-contact lens-related corneal infection on a background of viral keratitis, resulting in corneal abscess formation with subsequent corneal perforation. An 89-year-old Caucasian lady presented with a significant epithelial defect and a dense stromal infiltrates on a background of herpes zoster keratitis, ultimately resulting in corneal perforation. Enrichment culture obtained from corneal scraping isolated the unusual organism . This was treated with a combination of culture-directed, targeted course of antibiotics and surgical interventions. To the best of our knowledge, this is the first reported case of profuse bacterial keratitis secondary to infiltration, on a background of viral keratitis, resulting in corneal abscess formation and subsequent perforation. This report highlights this rare bacterium's characteristics including its pathogenicity in causing severe corneal disease, particularly in immunosuppressed environments such as in this case, apparent antibiotic sensitivities & resistance, and potential transmission route.
我们报告了一例罕见病例，在病毒性角膜炎背景下发生严重的、与隐形眼镜无关的角膜感染，导致角膜脓肿形成并随后发生角膜穿孔。一名89岁的白种女性，在带状疱疹性角膜炎背景下出现明显的上皮缺损和致密的基质浸润，最终导致角膜穿孔。从角膜刮片中获得的富集培养物分离出了这种不寻常的微生物。采用针对培养结果的靶向抗生素疗程与手术干预相结合的方法对其进行治疗。据我们所知，这是首例报道的在病毒性角膜炎背景下继发浸润性大量细菌性角膜炎，导致角膜脓肿形成并随后穿孔的病例。本报告突出了这种罕见细菌的特征，包括其在引起严重角膜疾病中的致病性，特别是在本例这样的免疫抑制环境中，其明显的抗生素敏感性和耐药性，以及潜在的传播途径。
