Mycobacterium chelonae keratitis associated with soft contact lens wear

To report a case of Mycobacterium chelonae keratitis associated with soft contact lens wear.

A 17-year-old boy who wore frequent replacement soft contact lenses developed keratitis in the right eye. There was no history of trauma to the right eye. The patient was treated initially with topical ciprofloxacin but without improvement. On presentation, visual acuity in his right eye was 20/40. A Gram-stained scraping of the corneal infiltrate revealed beaded filamentous rods, and the organisms were acid-fast positive. The patient's right eye was treated with intensive topical amikacin, 20 mg/mL, and 10 % sulfacetamide. Eventually, Mycobacterium chelonae was cultured on Sabourard's agar, topical sulfacetamide was stopped, and amikacin was continued.

The patient's keratitis responded well to amikacin and resolved over a period of 4 weeks. Visual acuity in the right eye improved to 20/25.

Mycobacterium chelonae is a rare cause of keratitis in soft contact lens wearers. We have identified fewer than five cases of Mycobacterium chelonae keratitis associated with soft contact lenses in the literature. Prompt and accurate diagnosis of the organism using comeal scraping can lead to appropriate therapy and resolution of the keratitis.