Turicella otitidis: a rare agent causing microbial keratitis

2021 ◽  
Vol 14 (7) ◽  
pp. e241371
Author(s):  
Smruti Rekha Priyadarshini ◽  
Himanshu Sekhara Behera ◽  
Srikant Sahu ◽  
Anirban Dutta
Keyword(s):  
Literature Search ◽  
Corneal Ulcer ◽  
Tissue Adhesive ◽  
Microbial Keratitis ◽  
Gram Staining ◽  
Corynebacterium Species ◽  
Bacterial Aetiology ◽  
Corneal Scraping ◽  
Alkali Injury ◽  
Adhesive Application

A 10-year-old boy treated for alkali injury with multiple interventions presented with a perforated corneal ulcer with clinically suspected bacterial aetiology. Cornea scraping and tissue adhesive application were planned. During surgery, an eyelash was found embedded at the perforated site. Gram staining of corneal scraping revealed the presence of Gram-positive bacilli on the first day which later was identified as Turicella otitidis with culture followed by VITEK V.2.0 (Biomerieux) identification. The bacterium was found to be sensitive to amikacin, ciprofloxacin, cefazolin, gatifloxacin, moxifloxacin, ofloxacin and vancomycin antibiotics as per Clinical and Laboratory Standards Institute guidelines. Coryneform bacteria is a rare cause of keratitis, and this is the first reported case of microbial keratitis caused by one of the rare corynebacterium species T. otitidis to the best of our knowledge. Literature search does not reveal any specific ocular features typical to this organism. This case supports the growing evidence for pathogenicity of T. otitidis in ocular samples. This study demonstrates the utility of VITEK for the identification of rare pathogen and may facilitate the use of certain antibiotics in the treatment regimen of T. otitidis infections.

scholarly journals Microbial keratitis: A five years retrospective clinical study in tertiary eye hospital of eastern region of Nepal

2017 ◽  
Vol 4 (4) ◽  
pp. 118-125
Author(s):  
Lila Raj Puri ◽  
Gauri Shankar Shrestha
Keyword(s):  
Visual Acuity ◽  
Clinical Study ◽  
Clinical Features ◽  
Corneal Ulcer ◽  
Health Concern ◽  
Eye Drops ◽  
Microbial Keratitis ◽  
Corneal Ulcers ◽  
Retrospective Clinical Study ◽  
Corneal Scraping

Background: Corneal ulcer is a sight threatening disease of significant public health concern. Early diagnosis with microbiological identification of the causative organism and institution of the proper medical therapy are important for successful visual recovery.Objectives: To find out the demographic and predisposing factors associated with corneal ulcers, evaluate management of ulcers on the basis of clinical features and corneal scraping results.Methods: It was a retrospective clinical study conducted among 1897 subjects with microbial keratitis in Sagarmatha Choudhary Eye Hospital, Lahan, Nepal from January 2010 to December 2014. Assessment included detailed eye examination with slit lamp for size, depth and location of ulcer, presenting visual acuity on internally illuminated Snellen’s chart, and corneal scrapings for Gram’s stain and 10% Potassium hydroxide wet mount. A standard treatment was delivered on the basis of clinical features and corneal scraping results. Subjects were evaluated subsequently after 48 hours, one week, two weeks, three weeks and four weeks of initiation of therapy. Non-responding cases were admitted to perform re-scraping and to modify therapy.Results: Majority of subjects (71.2%) belonged to the age group of 26 to 55 years  (71.2%), presented after two weeks (82.3%) and used non-prescription eye drops (71.9%) before visiting to the eye hospital. Ocular trauma (54.5%) was the most commonly reported predisposing factor. The central and paracentral ulcers comprised of 72.8% of ulcers withsize greater than 2mm in 2.7% and moderate ulcer in 71.1%. Microbiological test revealed fungal ulcers in 78.1% subjects. Presenting visual acuity better than 6/18 was reported in 7% only.Conclusion: Corneal ulcer was one of the commonly reported eye disease in Terai region of Nepal. Trauma is the commonest cause of corneal infection. Fungal corneal ulcers werecommonly noted.

scholarly journals Organism Isolation in Corneal Ulcer- Utility of Different Techniques

2012 ◽  
Vol 52 (185) ◽  
Author(s):  
M Thapa ◽  
A K Sharma ◽  
D N Shah ◽  
S KC ◽  
S Shrestha
Keyword(s):  
Corneal Ulcer ◽  
Descriptive Study ◽  
Microbial Keratitis ◽  
Cross Sectional ◽  
Corneal Ulcers ◽  
Isolation Techniques ◽  
Corneal Scraping ◽  
Microbial Agents ◽  
Culture Negative ◽  
Corneal Biopsy

Introduction: Various techniques are available for isolation of microorganism in cases of microbial keratitis including conventional methods of scraping, re-scraping inoculation in different media and corneal biopsy. Methods: This was a cross sectional descriptive study conducted from February 2002 to July 2003. A total of 161 eyes of corneal ulcers were evaluated with scraping inoculation. Re-scraping and corneal biopsy were performed in those cases which did not grow any organism in the first scraping or which did not respond to initial treatment. Results: Microorganisms were isolated in 116 patients (72.04%) after first scraping. S pneumoniae was seen in 50(42%), Fusarium in 21(18%) and Aspergillus in 16(14%) cases. Re-scraping was done in 22 culture negative and non improving cases of which 14 (63.63%) showed isolation of organisms. After re-scraping, Fusarium and Aspergillus were isolated in four patients each (18% each) followed by S. pneumoniae in 3 (14%), S. aureus in 2 (9%), and Penicillium in 1(5%) case.Corneal biopsy was done in 10 cases with isolation of microbial agents in 7 (70%) with Aspergillus and S. aureus in three each, and S. epidermidis in 1(10%). Conclusions: Apart from conventional scraping, other isolation techniques should be considered in the treatment of non-responding and culture negative cases of corneal ulcers. Compared to bacteria, fungi are difficult to isolate in the first scraping and requires more frequent repeat scraping and corneal biopsy. Keywords: Corneal biopsy, corneal scraping, corneal ulcer, microbial keratitis, organismal isolation.

scholarly journals A ten-year report of microbial keratitis in pediatric population under five years in a tertiary eye center

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Mohammad Soleimani ◽  
Seyed Ali Tabatabaei ◽  
S. Saeed Mohammadi ◽  
Niloufar Valipour ◽  
Arash Mirzaei
Keyword(s):  
Pediatric Population ◽  
Cross Sectional Study ◽  
Eye Drops ◽  
Microbial Keratitis ◽  
Cyanoacrylate Glue ◽  
Cross Sectional ◽  
Under Five ◽  
Fluoroquinolone Antibiotics ◽  
Empiric Antibiotic ◽  
Corneal Scraping

Abstract Purpose To report characteristics of microbial keratitis in pediatric patients under five years. Methods Patients with infectious keratitis under the age of 5 years were included in this retrospective cross-sectional study for ten years. All patients were admitted and corneal scraping was performed in 81 children. Fortified empiric antibiotic eye drops including cefazolin (50 mg/cc) and amikacin (20 mg/cc) were started and the antibiotic regimen was continued or changed according to culture results. In the case of fungal keratitis, topical voriconazole (10 mg/cc) or natamycin (50 mg/cc) and topical chloramphenicol (5 mg/cc) were started. A tectonic procedure was done when corneal thinning or perforation was present. Results Ninety-Three Patients between 1 to 60 months with a mean age of 33 ± 18 months old with corneal ulcer were included in the study. The most common risk factor was trauma (40.9%) followed by contact lens use (8.6%). Cultures were negative for microbial growth in 28 (30.1%) patients. The most common pathogens were S. epidermidis (10.8%) and P. aeruginosa (10.8%). Fluoroquinolone antibiotics (ciprofloxacin; 93.8% sensitivity) were the most potent antibiotic against bacterial pathogens. Forty-one patients underwent tectonic procedures, which the most common ones were cyanoacrylate glue 18.3% followed by keratoplasty 16.1%. Conclusion This study emphasizes the role of trauma as the primary cause and S. epidermidis as the most frequent microorganism in pediatric keratitis; according to antibiogram results and poor cooperation of patients under five years, monotherapy with fluoroquinolones could be a good regimen in small non-central lesions without thinning.

scholarly journals Outcomes of Cyanoacrylate Tissue Adhesive Application in Corneal Thinning and Perforation

Cornea ◽  
2019 ◽  
Vol 38 (6) ◽  
pp. 668-673 ◽  
Author(s):  
Jia Yin ◽  
Rohan Bir Singh ◽  
Rani Al Karmi ◽  
Ann Yung ◽  
Man Yu ◽  
...  
Keyword(s):  
Tissue Adhesive ◽  
Adhesive Application ◽  
Corneal Thinning

scholarly journals Kingella kingaeKeratitis in a Child with Underlying Vernal Keratoconjunctivitis

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Salim Nurul-Laila ◽  
Khai-Siang Chai ◽  
Ahmad Tajudin Liza-Sharmini ◽  
Ismail Shatriah
Keyword(s):  
Young Child ◽  
Young Children ◽  
Respiratory Tract ◽  
Corneal Ulcer ◽  
Vernal Keratoconjunctivitis ◽  
Causative Organism ◽  
Kingella Kingae ◽  
Corneal Scraping

Kingella kingaehad rarely been reported as a causative organism for corneal ulcer and had not been described before in vernal keratoconjunctivitis (VKC). Generally regarded as commensals of respiratory tract particularly in young children, it had however been isolated from the corneal ulcer scraping of both adult and children. We report a case of bacterial ulcer with isolation ofKingella kingaefrom the corneal scraping in a young child with underlying VKC.

scholarly journals A Severe Case ofArthrographis kalraeKeratomycosis

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Siti Roszilawati Ramli ◽  
Alex Lourdes Francis ◽  
Yushaniza Yusof ◽  
Tzar Mohd Nizam Khaithir
Keyword(s):  
Visual Acuity ◽  
Foreign Body ◽  
Amphotericin B ◽  
Corneal Ulcer ◽  
Surgical Intervention ◽  
Severe Case ◽  
Corneal Scraping ◽  
Loss Of Visual Acuity

A 52-year-old man with diabetes developed a unilateral central corneal ulcer after accidental foreign body inoculation. He complained of pain and loss of visual acuity in the injured eye, which displayed redness and edema and eventually discharged pus. A corneal scraping from the left eye orbit revealed fungal elements, and cultures of the material grew a fungus. The isolate was identified asArthrographis kalraebased on gross and microscopic morphologies. The patient received amphotericin B intravenously and itraconazole orally. The wound healed following surgical intervention, but the patient lost the use of his left eye.

scholarly journals Tegaderm transparent dressing (3M) with antibiotic ointment for treatment of infectious corneal ulcer: Antibiotic Wet Therapy

2021 ◽  
Author(s):  
Shingo Yasuda ◽  
Takayoshi Sumioka ◽  
Yukihisa Takada ◽  
Yuka Okada ◽  
Shizuya Saika
Keyword(s):  
Staphylococcus Aureus ◽  
Filamentous Fungi ◽  
Initial Treatment ◽  
Corneal Ulcer ◽  
Superficial Layer ◽  
University Hospital ◽  
Causative Organism ◽  
Gram Staining ◽  
Medical University ◽  
Antibiotic Ointment

Abstract Purpose To retrospectively review cases of infectious corneal ulcer treated with Tegaderm transparent dressing (3M) with an antibiotic ointment. Subjects and methods: A series of 29 eyes of 29 patients with possible infectious corneal keratitis were treated in Wakayama Medical University Hospital between January 1st, 2016 and December 31st, 2018. The age of the patients ranged from 26 to 92 years (mean 68.0 ± 17.8). At the first visit, the corneal infection lesion was scraped from the epithelium to the substantially superficial layer, and the scraped matter was submitted to Gram staining and culture examination. Cases suspected of fungi and Acanthamoeba were examined directly with potassium hydroxide (KOH) treatment. For several days until drug sensitivity results were obtained, initial treatment was Antibiotic Wet Therapy (AWT) with ophthalmic eye ointment and transparent Tegaderm (3M) dressing. We retrospectively reviewed the culture results of corneal scrapings (detected bacteria and drug resistance) and the therapeutic outcome of AWT. Results Nineteen eyes in which the causative bacteria were not identified and five eyes in which the causative bacteria (Pseudomonas aeruginosa, methicillin-susceptible Staphylococcus aureus (MSSA), Streptococcus, Corynebacterium.) were identified were successfully treated using AWT with ofloxacin ointment. methicillin-resistant Staphylococcus aureus (MRSA) was detected in 3 of 5 eyes in which AWT with ofloxacin was not successful, and filamentous fungi were detected in one eye. Two of the three eyes MRSA detected were healed by changing to vancomycin hydrochloride eye ointment, one of which was severely affected and was later enucleated. One eye with filamentous fungi was treated after changing to pimaricin eye ointment. A causative pathogen was not identified in the other eye, but because it was suspected to be fungal the ointment was changed to a pimaricin eye ointment, which led to healing. Conclusion AWT may be an option for initial treatment of corneal infections when the causative organism is unknown.

scholarly journals Study of keratomycosis at a tertiary care teaching hospital

2021 ◽  
Vol 7 (2) ◽  
pp. 65-70
Author(s):  
Veluri Gayathri ◽  
Ami Jeswin
Keyword(s):  
Corneal Ulcer ◽  
Fusarium Species ◽  
Tertiary Care ◽  
Fungal Keratitis ◽  
Care Hospital ◽  
Predisposing Factor ◽  
Corneal Ulcers ◽  
Detection And Identification ◽  
Bacterial Aetiology ◽  
A Prospective Study

Corneal infections are one of the leading causes of ocular morbidity and blindness world-wide. If normal defence mechanisms of the eye are compromised, almost any microorganism can invade the cornea. It is important to know the exact aetiology of corneal ulcer to institute appropriate therapy in time, least serious consequences may follow.  To isolate and identify the fungi from corneal scrapings of suspected keratitis patients. A prospective study of Fungal keratitis was conducted at Al-Azhar Medical College & Super Speciality Hospital in Thodupuzha, Kerala a tertiary care hospital with a capacity of 650 beds. The duration of the study was two years from January 2018 to January 2020. Patients with suspected fungal corneal ulcers presenting in the Out-Patient Department (OPD) of Ophthalmology were investigated for fungal etiology in the Department of Microbiology were included in this study. Each patient was examined with slit lamp. Data collected from history given by patient and patient examination. Using standard techniques. The specimens collected were then smeared on two slides, which were stained with Gram stain (for bacterial keratitis) and 10% potassium hydroxide preparation (for fungal keratitis) studied under light microscope. Of the 866 patients with corneal ulcer investigated, 83 cases with fungal and 36 with bacterial aetiology was identified. Males were more commonly affected and were mostly in the age group of 31-40 year. It was seen that trauma was the most common predisposing factor especially in the agriculturists and the farmers. Among the identified fungi, most were hyaline. Of the 83 positive specimens, the most frequent agent isolated was Fusarium species in 31 (37.3%) cases. 23 (27.7%) was the second most common followed by , ., . Candida albicans were 5 (6%) followed by 1 (1.2%). Fungal Keratitis is a serious problem usually following corneal trauma, it requires rapid detection and identification of fugal agents for treatment to prevent disastrous consequences.

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