Severe Keratitis and Corneal Perforation by Paenibacillus glucanolyticus

Abstract

To report the first case of Paenibacillus glucanolyticus, a spore-forming bacteria, to be isolated in a human ocular infection. We describe a severe case of noncontact lens-related microbial keratitis due to P. glucanolyticus presenting with a large corneal abscess, severe ocular inflammation, and a large epithelial defect. The corneal scrapes with no growth initially cultured P. glucanolyticus on blood agar after 48 hours, with sensitivity to gentamicin and fluoroquinolones. No other organism was cultured. The patient had severe keratitis with a protracted course requiring cyanoacrylate glue patching because of keratolysis and perforation. The patient may benefit from a penetrating keratoplasty and extracapsular cataract extraction in due course to aid visual rehabilitation. This is the first reported ocular case of P. glucanolyticus demonstrating its bacterial virulence and pathogenic potential when infecting the cornea. Rapid identification with newer technology enable us to accurately identify these opportunistic bacteria and may give a more favorable visual outcome as correct sensitivities lead to timely treatment administration.