A rare case of mixed infectious keratitis caused by Pseudomonas koreensis and Aspergillus fumigatus

Khoo, L. W., Srinivasan, S. S., Henriquez, F. L. and Bal, A. M. (2020) A rare case of mixed infectious keratitis caused by Pseudomonas koreensis and Aspergillus fumigatus. Case Reports in Ophthalmology, 11(3), pp. 600-605. (doi: 10.1159/000510571) (PMID:33437234) (PMCID:PMC7747071)

Abstract

We report the clinical and microbiological features of contact lens-related mixed infectious keratitis caused by a spore-forming filamentous fungus and a rare gram-negative bacterial infection. A 66-year-old Caucasian female presented with right eye (OD) pain after sleeping in her 2-weekly contact lenses for 3 days. On presentation, corrected distance visual acuity was 0.46 LogMAR OD and 0.20 in the left eye. Slit lamp biomicroscopy revealed a 1.9 mm by 1.9 mm area of dense stromal infiltrate with epithelial defect. Corneal scrapes grew <i>Aspergillus fumigatus</i> and <i>Pseudomonas koreensis</i>, and culture-directed microbial therapy with oral and topical voriconazole and topical fortified gentamicin along with regular debridement resulted in slow resolution of the infection, leaving a dense stromal scar in the visual axis requiring penetrating keratoplasty. Mixed infectious keratitis caused by filamentous fungi and gram-negative bacteria is rare. <i>Pseudomonas koreensis</i> infection has not been previously reported as a cause of infectious keratitis in humans. In our experience, these mixed infections require prolonged systemic and topical therapy and the secondary scarring may require surgical intervention for vision rehabilitation.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Henriquez, Dr Fiona and Khoo, Dr Lin and Bal, Dr Abhijit and Srinivasan, Mr Sathish
• Authors: Khoo, L. W., Srinivasan, S. S., Henriquez, F. L., and Bal, A. M.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Case Reports in Ophthalmology
• Publisher: Karger Publishers
• ISSN: 1663-2699
• ISSN (Online): 1663-2699
• Published Online: 09 November 2020
• Copyright Holders: Copyright © 2020 The Authors
• First Published: First published in Case Reports in Ophthalmology 11(3): 600-605
• Publisher Policy: Reproduced under a Creative Commons License