Korean J Ophthalmol.  2012 Feb;26(1):49-53. 10.3341/kjo.2012.26.1.49.

Achromobacter xylosoxidans Keratitis after Contact Lens Usage

• Park JH
• Song NH
• Koh JW

• KMID: 1120182
• DOI: http://doi.org/10.3341/kjo.2012.26.1.49

Abstract

To report on Achromobacter xylosoxidans keratitis in two healthy patients who had worn contact lenses foran extended period of time. A 36-year-old female and a 21-year-old female visited our hospital with ocular pain and blurred vision. Both patients had a history of wearing soft contact lenses for over fve years with occasional overnight wear. At the initial presentation, a slit lamp examination revealed corneal stromal infiltrations and epithelial defects with peripheral neovascularization in both patients. Microbiological examinations were performed from samples of corneal scrapings, contact lenses, contact lens cases, and solution. The culture resulting from the samples taken from the contact lenses, contact lens cases, and solution were all positive for Achromobacter xylosoxidans. Confrming that the direct cause of the keratitis was the contact lenses, the frst patient was prescribed ceftazidime and amikacin drops sensitive to Achromobacter xylosoxidans. The second patient was treated with 0.3% gatifoxacin and fortifed tobramycin drops. After treatment, the corneal epithelial defects were completely healed, and subepithelial corneal opacity was observed. Two cases of Achromobacter xylosoxidans keratitis were reported in healthy young females who wore soft contact lenses. Achromobacter xylosoxidans should be considered a rare but potentially harmful pathogen for lens-induced keratitis in healthy hosts.

Keyword

Achromobacter xylosoxidans; Keratitis; Hydrophilic contact lenses

MeSH Terms

Achromobacter denitrificans/*isolation & purification
Adult
Amikacin/administration & dosage
Anti-Bacterial Agents/*administration & dosage
Ceftazidime/administration & dosage
Contact Lenses, Extended-Wear/*adverse effects
Female
Fluoroquinolones/administration & dosage
Gram-Negative Bacterial Infections/diagnosis/*drug therapy/*microbiology
Humans
Keratitis/diagnosis/*drug therapy/*microbiology
Tobramycin/administration & dosage

Figure

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  Fig. 1 (A) The slit-lamp photograph at the first visit revealed a 0.5 × 0.7 mm-sized round corneal epithelial defect with stromal infiltration. (B) Seven days after treatment, the corneal lesion exhibited complete epithelialization with subepithelial corneal opacity.

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  Fig. 2 (A) Multiple colonies were formed on the MacConkey agar, and each colony exhibited a non-pigmented, dome-shaped cluster. (B) Gram staining showed various sizes of Gram-negative bacilli (Gram stain, ×1,000).

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  Fig. 3 (A) Slit-lamp photography at the first visit showed a 0.5 × 0.5 mm-sized, round corneal epithelial defect with stromal infiltration at the 7 o'clock direction. (B) Seven days after treatment, the corneal lesion showed complete epithelialization with subepithelial corneal opacity.

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