Korean J Ophthalmol.  2008 Mar;22(1):49-52. 10.3341/kjo.2008.22.1.49.

Experience of Comamonas Acidovorans Keratitis with Delayed Onset and Treatment Response in Immunocompromised Cornea

• Lee SM
• Kim MK
• Lee JL
• Wee WR
• Lee JH

• KMID: 1107491
• DOI: http://doi.org/10.3341/kjo.2008.22.1.49

Abstract

PURPOSE: To report 2 cases of Comamonas acidovorans keratitis in immunocompromised cornea. METHODS: A complete review of the medical records of the two cases of Comamonas acidovorans keratitis. RESULTS: We found some similarities in clinical courses of two cases. Both of them showed development of keratitis during the management with corticosteroids, delayed onset, slow response to antibiotics, and relatively less affected corneal epithelium. CONCLUSIONS: Comamonas acidovorans is known as a less virulent organism. However it can cause an indolent infection that responds slowly even to adequate antibiotics therapy in immunocompromised corneas.

Keyword

Comamonas acidovorans; Keratitis; Immunocompromised

MeSH Terms

Amikacin/therapeutic use
Anti-Bacterial Agents/therapeutic use
Ceftazidime/therapeutic use
Ciprofloxacin/therapeutic use
Corneal Ulcer/diagnosis/drug therapy/*microbiology
Delftia acidovorans/*isolation & purification
Drug Therapy, Combination
Eye Infections, Bacterial/diagnosis/drug therapy/*microbiology
Gram-Negative Bacterial Infections/diagnosis/drug therapy/*microbiology
Humans
*Immunocompromised Host
Male
Microbial Sensitivity Tests
Middle Aged

Figure

• 

  Fig. 1 Case 1 with necotizing scleritis and C. acidovorans keratitis. (A) A large scleral defect with an overlying partial epithelial defect and diffuse scleral injection was noted. A small round stromal opacity (arrow) was observed in the corneal wound that had been made 1 year before, at pre-ulcerative stage. (B) Dense stromal infiltration was noted with endothelial plaque and a shallow epithelial defect in the previous surgical wound, while in treatment of scleritis. (C) Amniotic membrane was grafted for the deep ulcer after 5 weeks of treatment because there was no decrease in stromal infiltration. Keratitis with endophthalmitis was completely cured 7 weeks after the initial diagnosis.

• 

  Fig. 2 Case 2 with C. acidovorans keratitis after penetrating keratoplasty. (A) Corneal ulceration with stromal infiltration was observed in the temporal area of previous donor cornea. (B) After 2 weeks of treatment, the epithelial defect was healed and the infiltration in corneal stroma had decreased. (C) Corneal allograft rejection developed after infection had been finally controlled.

Reference

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