Abstract
Purpose. To present a case of infectious keratitis caused by the microorganism Serratia marcescens in a contact lens user and further to confer on the most advantageous management of comparable situations. Case. After altering the routine that she used for contact lens disinfection, a 24-year-old patient presented with pain and conjunctival redness in both eyes. Slit-lamp examination revealed two infiltrates in the inferior part of the cornea in the right eye and five smaller infiltrates in the superior half of the left cornea. Appropriate treatment, after hospitalization, improved the symptoms while culture of the contact lens material revealed Serratia marcescens as the responsible infectious factor. Conclusion. Enhancing the availability of information with respect to contact lens users and customized analysis regarding treatment for a particular complication could be beneficial in order to reduce the frequency of admission to the eye clinic due to infectious keratitis. In addition, rapid laboratory testing of the infected materials should be a priority for selection of the optimal treatment regimen.
Highlights
Serratia species are opportunistic Gram-negative bacteria classified in the tribe Klebsielleae and the large family Enterobacteriaceae
Serratia marcescens is a potential cause of infectious keratitis that appears to be associated with abnormal corneal surface, topical medications, and contact lens wear
Current guidelines [4] suggest that admission to the hospital because of keratitis may be necessary if (i) the infection is sight-threatening, (ii) the patient has difficulty administering the antibiotics at the prescribed frequency, (iii) there is high likelihood of noncompliance with drops or daily followup (iv) suspected topical anaesthetic abuse, (v) intravenous antibiotics are needed
Summary
Serratia species are opportunistic Gram-negative bacteria classified in the tribe Klebsielleae and the large family Enterobacteriaceae. The primary pathogenic species is Serratia marcescens [1]. Serratia marcescens is a potential cause of infectious keratitis that appears to be associated with abnormal corneal surface, topical medications, and contact lens wear. Proper medical treatment results in a good clinical response in most cases [2, 3]. Current guidelines [4] suggest that admission to the hospital because of keratitis may be necessary if (i) the infection is sight-threatening,. (ii) the patient has difficulty administering the antibiotics at the prescribed frequency,. (iii) there is high likelihood of noncompliance with drops or daily followup (iv) suspected topical anaesthetic abuse,. (v) intravenous antibiotics are needed (e.g., corneal perforation, scleral extension of the infection, and gonococcal conjunctivitis with corneal involvement). Serratia endophthalmitis usually occurs after ocular surgery with poor prognosis [5,6,7]
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