J Korean Ophthalmol Soc.  2012 Aug;53(8):1163-1166. 10.3341/jkos.2012.53.8.1163.

Hafnia Alvei Keratitis after Using a Therapeutic Contact Lens in a Patient with Graft-Versus-Host Disease

• Park SU
• Lee SJ
• Lee SC

• KMID: 2215961
• DOI: http://doi.org/10.3341/jkos.2012.53.8.1163

Abstract

PURPOSE
To report a case of bacterial keratitis caused by Hafnia alvei after using a contact lens in a patient with graft-versus-host disease.
CASE SUMMARY
A 47-year-old male patient presented with a corneal ulcer. The patient had been wearing a therapeutic contact lens for a month because of severe dry eye syndrome and filament removal due to filamentary keratitis. The patient had been taking moxifloxacin to prevent infection, but had not for the previous 7 days. The corneal ulcer occurred at the 11 o'clock direction in the peripheral cornea accompanied by corneal epithelial defect and stromal infiltration. The corneal scraping and culture yielded Hafnia alvei, which is susceptible to ceftazidime, levofloxacin and moxifloxacin. There was no systemic signs or symptoms to suspect systemic infection. After treatment with a topical antibiotic agent, the patient's eye condition improved with only mild corneal opacity remaining.
CONCLUSIONS
Hafnia alvei infection rarely occurs in humans but should be considered as a potential causal pathogen in immunosuppressed patients.

Keyword

Contact lens; Graft-versus-host disease; Hafnia alvei

MeSH Terms

Aza Compounds
Ceftazidime
Cornea
Corneal Opacity
Corneal Ulcer
Dry Eye Syndromes
Eye
Graft vs Host Disease
Hafnia
Hafnia alvei
Humans
Keratitis
Male
Middle Aged
Ofloxacin
Quinolines
Aza Compounds
Ceftazidime
Ofloxacin
Quinolines

Figure

• 

  Figure 1 The slit-lamp photograph revealed corneal punctate epithelial erosions and filaments. Filament removal was done and therapeutic contact lens was applied.

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  Figure 2 The slit-lamp photograph at two months after contact lens application revealed a 1.0 mm × 1.0 mm-sized round corneal epithelial defect with stromal infiltration at the 11 o'clock direction.

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  Figure 3 Seven days after treatment with susceptible topical antibiotics, the corneal lesion showed complete epithelialization with faint corneal opacity.

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