J Korean Ophthalmol Soc.  2019 Aug;60(8):787-791. 10.3341/jkos.2019.60.8.787.

Infectious Keratitis Caused by Shewanella Putrefaciens

• Moon TK
• Ji YS
• Yoon KC

• KMID: 2455462
• DOI: http://doi.org/10.3341/jkos.2019.60.8.787

Abstract

PURPOSE
We report a case of infectious keratitis caused by Shewanella putrefaciens in a patient after fishing.
CASE SUMMARY
A 75-year-old male with no underlying disease other than hypertension was admitted to our hospital because of decreased visual acuity and congestion in his left eye for 2 weeks. At the first ophthalmic examination, the best-corrected visual acuity (BCVA) of the left eye was counting fingers. Slit lamp examination showed stromal infiltrates with 2.0 × 2.0 mm corneal epithelial defects, endothelial inflammatory plaques and 1 mm height hypopyon with severe inflammation in the anterior chamber. Bacterial culture tests were performed by corneal scraping, which were positive for Shewanella putrefaciens, followed by treatment with moxifloxacin and ceftazidime topical antibiotics. After 2 months of treatment, the BCVA of the left eye improved to 0.4 and the corneal lesion clinically improved with residual mild stromal opacity.
CONCLUSIONS
Shewanella putrefaciens should be considered as a causal pathogen of infectious keratitis in patients after fishing. We report a case of infectious keratitis caused by Shewanella putrefaciens, which has never previously been reported in the Republic of Korea.

Keyword

Corneal ulcer; Shewanella putrefaciens

MeSH Terms

Aged
Anterior Chamber
Anti-Bacterial Agents
Ceftazidime
Corneal Ulcer
Estrogens, Conjugated (USP)
Fingers
Humans
Hypertension
Inflammation
Keratitis*
Male
Republic of Korea
Shewanella putrefaciens*
Shewanella*
Slit Lamp
Visual Acuity
Anti-Bacterial Agents
Ceftazidime
Estrogens, Conjugated (USP)

Figure

• 

  Figure 1 Slit lamp photograph and anterior segment optical coherence tomography at the first ophthalmic examination. (A) Slit lamp photograph at the first ophthalmic examination showing infectious keratitis with central epithelial defects, stromal infiltrates, perilesional stromal edema and severe chamber reaction with linear hypopyon. (B) Anterior segment optical coherence tomography showing central stromal infiltrates, endothelial inflammatory plaques and edema.

• 

  Figure 2 Bacterial culture tests by corneal scraping. On blood agar plates, the Shewanella putrefaciens colonies are convex and large, with a brown pigment.

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  Figure 3 Slit lamp photographs at 1 week and 3 weeks after antibacterial treatments. (A) One week after antibacterial treatments, epithelial defects size, stromal infiltration and hypopyon decreased. (B) Three weeks of antibacterial treatments, the corneal lesions healed with a remaining stromal opacity.

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