BACKGROUND: Alcaligenes xylosoxidans can result in opportunistic infections in patients who are immunocompromised. Alcaligenes xylosoxidans keratitis is a rare infection, almost always occurring in a compromised cornea. Few reported cases have occurred as contact lens-induced keratitis. The purposes of this report are to report a case of A. xylosoxidans keratitis in an immunocompetent contact lens wearer (2-week disposable) and to review the related literature. METHODS: A 30-year-old man developed acute keratitis in the right eye. He was a 2-week disposable contact lens wearer. He did not report any ocular or systemic illness. Corneal scraping, contact lens, and conjunctiva cultures were performed. RESULTS: 0.5% moxifloxacin eye drops were started hourly with quick recovery and healing of the ulcer and epithelial defect noted within a few days. Culture of the contact lens was positive for A. xylosoxidans. The organism was sensitive to penicillins, third-generation cephalosporins, and fluoroquinolones but resistant to aminoglycosides. CONCLUSIONS: Alcaligenes xylosoxidans is a potential pathogen in compromised corneas. It has high susceptibility to extended-spectrum penicillins and current generations of fluoroquinolones but rarely responds to aminoglycosides. Alcaligenes xylosoxidans should be considered in the differential diagnosis of contact lens-induced keratitis.
BACKGROUND:Alcaligenes xylosoxidans can result in opportunistic infections in patients who are immunocompromised. Alcaligenes xylosoxidanskeratitis is a rare infection, almost always occurring in a compromised cornea. Few reported cases have occurred as contact lens-induced keratitis. The purposes of this report are to report a case of A. xylosoxidanskeratitis in an immunocompetent contact lens wearer (2-week disposable) and to review the related literature. METHODS: A 30-year-old man developed acute keratitis in the right eye. He was a 2-week disposable contact lens wearer. He did not report any ocular or systemic illness. Corneal scraping, contact lens, and conjunctiva cultures were performed. RESULTS: 0.5% moxifloxacin eye drops were started hourly with quick recovery and healing of the ulcer and epithelial defect noted within a few days. Culture of the contact lens was positive for A. xylosoxidans. The organism was sensitive to penicillins, third-generation cephalosporins, and fluoroquinolones but resistant to aminoglycosides. CONCLUSIONS:Alcaligenes xylosoxidans is a potential pathogen in compromised corneas. It has high susceptibility to extended-spectrum penicillins and current generations of fluoroquinolones but rarely responds to aminoglycosides. Alcaligenes xylosoxidans should be considered in the differential diagnosis of contact lens-induced keratitis.
Authors: Victor M Villegas; Andres Emanuelli; Harry W Flynn; Audina M Berrocal; Darlene Miller; Andrew A Kao; Sander R Dubovy; Eduardo Alfonso Journal: Retina Date: 2014-03 Impact factor: 4.256