A RETROSPECTIVE CASE SERIES OF MORAXELLA KERATITIS INFECTIONS

To analyse the clinical presentation, predisposing risk factors and outcomes of 5 cases of Moraxella catarrhalis keratitis.

A retrospective analysis was carried out of culture proved cases of Moraxella keratitis from hospital records, microbiology investigations and slit-lamp photos during a 2 year period (from June 2020 to June 2022). 

Moraxella keratitis was identified in 5 patients. The mean age of the patients was 61 years (range 49–74), 2 females, 3 males. Visual acuity at presentation was counting fingers or less in all cases. Common predisposing factors included alcohol dependency (3/5), heavy smoking (3/5), malnutrition (3/5), gardening/DIY work (3/5), herpetic disease and dry eyes (3/5). Common features included: large infiltrates at presentation (average 4x7mm), infero-central location, severe stromal loss and Descemet’s folds (5/5), corneal perforation (3/5), hypopyon (5/5) and intrastromal bleeding (3/5). All patients received a combination of fluoroquinolone and cephalosporins, topical steroids were started within the first 48 hours due to severe stromal loss. Adjunctive procedures with tissue adhesive and bandage contact lens (3/5) and surgical intervention with penetrating keratoplasty and/or cataract surgery (2/5) were necessary for visual rehabilitation.

Moraxella microbial keratitis is a rare infection presenting challenging features, fast progression into the corneal stroma with high incidence of early complications requiring surgical intervention and a poor visual outcome attributable to the nature of the infection and the predisposing factors. Early initiation of topical steroid appears a critical factor in the prevention of stromal melt. More research in the antimicrobial susceptibility of Moraxella infections is required to prevent sight threatening complications of this type of keratitis.