Contact Lens Related Elizabethkingia meningoseptica Keratitis- A First Southeast Asean Case Report & Literature Review.
Keywords:
Contact lens, Cornea and external disease, Elizabethkingia meningoseptica, KeratitisAbstract
We describe the first clinical case of contact lens related corneal ulcer caused by Elizabethkingia meningoseptica registered in Southeast Asia. A 20-year-old female student who was a regular soft contact lens wearer, presented with pain, photophobia and blurring of vision of the right eye for 3 days. On slit lamp examination, there was a small paracentral anterior stromal infiltrate with an overlying epithelial defect. Microbiological cultures from corneal scrapings, contact lens and its casing were positive for E. meningoseptica. Due to high likelihood of contact lens contamination causing keratitis, topical fortified gentamicin 0.9% and ceftazidime 5% were administered empirically. Topical vancomycin 5% was later added tailoring to the culture and sensitivity of the organism. After 8 weeks of treatment, the keratitis subsided and corneal epithelial defect completely healed with residual corneal opacity. Even though uncommon, contact lens related E. meningoseptica keratitis can occur in healthy immunocompetent individuals with no ocular comorbidities.References
King EO. Studies on a group of previously unclassified bacteria associated with meningitis in infants. Am J Clin Pathol. 1959; 31:241-247.
Bloch KC, Nadarajah R, Jacobs R. Chryseobacterium meningosepticum: an emerging pathogen among immuno¬compromised adults: report of 6 cases and literature review. Medicine. 1997; 76(1):30-41.
Chiu CH, Waddingdon M, Greenberg D, Schreckenberger PC, Carnahan AM. Atypical Chryseobacterium meningosepticum and meningitis and sepsis in newborns and the immunocompromised. Emerg Infect Dis. 2000; 6(5):481–486.
Hoque SN, Graham J, Kaufmann ME, Tabaqchali S. Chryseobacterium (Flavobacterium) meningosepticum outbreak associated with colonization of water taps in a neonatal intensive care unit. J Hosp Infect. 2001; 47(3):188-192.
Gungor S, Ozen M, Akinci A, Durmaz R. A Chryseobacte¬rium meningosepticum outbreak in a neonatal ward. Infect Control Hosp Epidemiol. 2003; 24(8):613-617.
Adachi A, Mori T, Shimizu T, Yokoyama A, et al. Chryseobacterium me¬ningosepticum septicemia in a recipient of allogeneic cord blood transplantation. Scand J Infect. 2004; 36:539-540.
LeFrancois M, Baum JL. Flavobacterium endophthalmitis following keratoplasty: use of a tissue culture medium-stored cornea. Arch Ophthalmol. 1976; 94(11):1907-1909.
Ceyhan M, Yildirim I, Tekeli A, Yurdakok M, Us E, et al. A Chryseobacterium meningosepticum outbreak observed in 3 clusters involving both neonatal and non-neonatal pediatric patients. Am J Infect Control. 2008; 36(6):453–457.
Essex RW, Charles PG, Allen PJ. Three cases of post-traumatic endophthalmitis caused by unusual bacteria. Clin Experiment Ophthalmol. 2004; 32(4):445–447.
Connell PP, Wickremasinghe S, Devi U, Waters MJ, Allen PJ. Self-induced Elizabethkingia meningoseptica endophthalmitis: A case report. J Med Case Rep. 2011; 5: 303.
Li EY, Jhanji V. Massive lipid keratopathy after Elizabethkingia meningosepticum keratitis. Cont Lens Anterior Eye. 2014; 37(1):55-56.
Erdem E, Abdurrahmanoglu S, Kibar F, Yagmur M, Koksal F, et al. Posttraumatic keratitis caused by Elizabethkingia meningosepticum. Eye Contact Lens. 2013; 39(5):361-363.
Bloom AH, Perry HD, Donnenfeld ED, et al. Chryseobacterium meningosepticum keratitis. Am J Ophthalmol. 2003; 136(2):356–357.
Beato JN, Espinar MJ, Figueira L, Eremina YO, Ribeiro M, et al.
Elizabethkingia meningoseptica and contact lens use. Acta Med Port. 2016; 29(4):287-289.
Yang YS, Chun JW, Koh JW. Keratitis with Elizabethkingia meningoseptica occurring after contact lens wear: A Case Report. Korean J Ophthalmol. 2013; 27(2):133-136.
Stapleton F, Edwards K, Keay L, Naduvilath T, Dart J, et al. Risk factors for moderate and severe microbial keratitis in daily wear contact lens users. Ophthalmology. 2012; 119(8):1516-1521.
Cheng KH, Leung SL, Hoekman HW, Beekhuis WH, Mulder PG, et al. Incidence of contact-lens-associated microbial keratitis and its related morbidity. Lancet. 1999; 354(9174):181–185.
Ladage PM, Ren DH, Petroll WM, Jester JV, Bergmansonet J, et al. Effects of eyelid closure and disposable and silicone hydrogel extended contact lens wear on rabbit corneal epithelial proliferation. Invest Ophthalmol Vis Sci. 2003; 44(5):1843–1849.
Ladage PM, Jester JV, Petroll WM, Bergmanson J, Cavanagh HD. Vertical movement of epithelial basal cells towards the corneal surface during use of extended-wear contact lenses. Invest Ophthalmol Vis Sci. 2003; 44(3):1056–1063.
Ladage PM, Yamamoto K, Ren DH, Li L, Jester JV, et al. Effects of rigid and soft contact lens daily wear on corneal epithelium, tear lactate dehydrogenase, and bacterial binding to exfoliated epithelial cells. Ophthalmology. 2001; 108(7):1279–1288.
Stapleton F, Kasses S, Bolis S, Keay L. Short term wear of high Dk soft contact lenses does not alter corneal epithelial cell size or viability. Br J Ophthalmol. 2001; 85(2):143–146.
Robertson DM. The effects of silicone hydrogel lens wear on the corneal epithelium and risk for microbial keratitis. Eye Contact Lens. 2013; 39(1):67-72.
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