J Korean Ophthalmol Soc.  2014 Jun;55(6):918-922.

A Case of Corneal Ulcer Caused by Leclercia Adecarboxylata

• Lee KI
• Chung SK
• Hwang HB

Abstract

PURPOSE
To report a case of corneal ulcer caused by Leclercia adecarboxylata in an immunocompetent patient.
CASE SUMMARY
A previously healthy 43-year-old female presented with right ocular pain and was referred to our clinic under the impression of corneal abrasion and secondary infection. The patient was treated at a local clinic for 3 days using artificial tears, therapeutic contact lens, topical antibiotics, and anti-inflammatory eye drops but showed no improvement. Gram staining, bacterial and fungal cultures and antibiotic sensitivity test were performed from a corneal scrape. The cultures revealed growth of Leclercia adecarboxylata. The patient was treated with moxifloxacin and ofloxacin eye drops. After 2 weeks of treatment, the infection resolved without remaining scars.
CONCLUSIONS
Reportedly, Leclercia adecarboxylata affects humans only as an opportunistic pathogen or part of polymicrobial infections. However, in the present case, Leclercia adecarboxylata was isolated as a single pathogen in an immunocompetent patient which is the first clinical report of this microorganism found in an ocular sample. Therefore, if antibiotic-susceptible gram-negative bacilli are found in opthalmologic samples, the above bacteria should be considerd in the diagnosis.

Keyword

Corneal ulcer; Gram-negative bacilli; Leclercia adecarboxylata

MeSH Terms

Adult
Anti-Bacterial Agents
Bacteria
Cicatrix
Coinfection
Corneal Ulcer*
Diagnosis
Enterobacteriaceae*
Female
Humans
Ofloxacin
Ophthalmic Solutions
Anti-Bacterial Agents
Ofloxacin
Ophthalmic Solutions

Figure

• 

  Figure 1. (A) Anterior segment photograph at the first oph-thalmic examination showing a corneal ulcer with deep stromal infiltrations and linear hypopyon. (B) Corneal ulcer with de-creased stromal infiltration and remaining hypopyon on the 2nd day of antibacterial treatment. (C) Nearly regressed corneal ul-cer on the 7th day of antibacterial treatment.

• 

  Figure 2. (A) Anterior segment photograph (Fluorescein dye stained) on the 3rd day after starting anti-bacterial treatment; better marginated corneal ulcer with decreased stromal infiltration. (B) Anterior segment photograph (Fluorescein dye stained) on the 5th day showing decreased epithelial defects with remnant bacterial collections at the inferior cornea.

Reference

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