J Korean Ophthalmol Soc.  2015 Apr;56(4):607-613. 10.3341/jkos.2015.56.4.607.

Clinical Features of Acinetobacter Baumannii Keratitis

• Shin KY
• Cho KJ

• KMID: 2215714
• DOI: http://doi.org/10.3341/jkos.2015.56.4.607

Abstract

PURPOSE
Acinetobacter species are common aerobic gram-negative bacterium that contain polymorphisms. Acinetobacter baumannii keratitis has recently received attention, and has various clinical features. Therefore, it is crucial to determine the appropriate medical treatment for Acinetobacter baumannii keratitis.
CASE SUMMARY
There were two infectious crystalline keratitis patients, two other patients that were co-infected with fungus, and the last patient who had the peripheral corneal ulcer type of keratitis.
CONCLUSIONS
Acinetobacter baumannii keratitis demonstrates multiple clinical features. It forms a biofilm that can bring possible resistance to therapy, and it can also co-infect with fungus. In contrast to general bacterial keratitis which occurs in the form of a central corneal ulcer, we found Acinetobacter baumannii to take on the form of a peripheral corneal ulcer in our experiments on the five keratitis patients. Although Acinetobacter species were originally found to be multidrug-resistant, such resistance was not found in our experiments. However, due to the various problems associated with Acinetobacter baumannii, it is always critical for medical staff to take infection of Acinetobacter baumannii into consideration in keratitis patients.

Keyword

Acinetobacter baumannii; Keratitis

MeSH Terms

Acinetobacter
Acinetobacter baumannii*
Biofilms
Corneal Ulcer
Crystallins
Fungi
Humans
Keratitis*
Medical Staff
Crystallins

Figure

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  Figure 1. (A) Slit-lamp photograph shows the presence of crystal-like white stromal infiltrations with epithelial defect at the center. (B) Six month after treatment.

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  Figure 2. (A) Corneal infiltration in the anterior stroma with conjunctival injection. (B) Two month after treatment.

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  Figure 3. Anterior segment optical coherence tomography (AS-OCT) shows relatively well demarcated horizontal infiltration in the anterior stroma (A: patient 1; B: patient 2).

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  Figure 4. (A) Corneal ulcer with descemetocele at the nasal area, infiltrations at superior limbus. (B) Two days after therapeutic partial keratoplasty, there is immune ring-like infiltration (white arrows). (C) Stromal necrosis at center of cornea (yellow arrows). (D) After therapeutic keratoplasty.

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  Figure 5. (A) Corneal infiltration with feathery margin, epithelial defect at the center of infiltration and conjunctival injection. (B) Two month after treatment.

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  Figure 6. (A) Peripheral corneal ulcer with stromal infiltration. (B) One month after treatment.

Reference

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