INFECTIOUS KERATITIS DUE TO MORAXELLA LACUNATA: A CASE REPORT

Published 2022 - 26th ESCRS Winter Meeting

Reference: CR05 | Type: Cornea Day Case Presentations | DOI: 10.82333/d3ac-nz04

Authors: Ana Maria Ceausescu* ¹ , Maria Caridad Martinez Hergueta ² , Clara Pilar Ruiz Belda ¹ , Carlos Garcia Vicente ¹ , Carmen Vivo Devesa ¹

¹Department of Ophthalmology,Marina Baixa Hospital, Villajoyosa 03570, Alicante, Spain,Alicante,Spain, ²Department of Ophthalmology,Elda General University Hospital,Elda,Spain

To describe the Clinical Characteristics, Management, and Treatment of Moraxella lacunata keratitis.

Department of Ophthalmology, Marina Baixa Hospital, Villajoyosa 03570, Alicante, Spain.

A 53-year-old man presented to our emergency department with a 3-days history of pain, photophobia, and decreased vision in his right eye. Previous ocular, medical and family histories were unremarkable except for smoking. His best-corrected visual acuity was 20/100 in the right eye and 20/20 in the left eye. Intraocular pressure was normal in both eyes.

Slit-lamp biomicroscopy of his right eye revealed a ciliary injection and a central corneal infiltration with an extensive epithelial defect. We performed corneal ulcer scraping and after that we started topical treatment with fortified ceftazidime 50 mg/ml and tobramycin 15mg/ml every hour. We added also cyclopentolate 0.5% twice a day.

After two days of intensive treatment the clinical features worsened with the appearance of hypopyon and an increase in stromal infiltration and more epithelial defect.

The culture results revealed Moraxella lacunata sensitive to ceftazidime, moxifloxacin, gentamicin, and amikacin and we decided to change the treatment replacing tobramycin with moxifloxacin.

After shifting the topical antibiotics, the keratitis was controlled and 2 months later the patient presented a paracentral corneal leucoma and his best-corrected visual acuity has improved to 20/30.

The corneal infection caused by Moraxella species characteristically has an indolent paracentral or peripheral ulcer that is usually oval in shape and associated with hypopyon or hyphema.

Microbial keratitis is a serious ocular infectious disease characterized by a corneal epithelial defect and underlying stromal infiltrate that can lead to significant stromal scarring, corneal perforation, and visual loss.

Appropriate therapy is very important and topical antibiotics remain the best treatment for bacterial keratitis. Empirical treatment with broad spectrum antibiotics, usually fortified aminoglycoside–cephalosporin or topical fluoroquinolone, is often the primary therapy which can then be modified according to cultured organisms and antibiotic sensitivities.