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Acinetobacter as a causative agent in preseptal cellulitis
1Northeastern State University, College of Optometry, Tahlequah, Oklahoma 74464, USA. millerjm@nsuok.edu
Background:
The bacterial genus Acinetobacter, once viewed as inconsequential, has been increasingly implicated as a significant pathogen. Acinetobacter is becoming progressively more resistant to older and newer-generation antibiotics. The primary species encountered in infections is Acinetobacter baumannii.
Case Report:
A 39-year-old woman came in for treatment of a preseptal cellulitis and conjunctivitis. She was referred to W.W. Hastings Optometry Clinic eleven days after first being diagnosed with a hordeolum that developed into a preseptal cellulitis, despite the use of oral cephalexin anazithromycin. After being referred, the patient was placed on oral regimen of gatifloxacin and topical ciprofloxacin. The patient gradually improved over the next 10 days, with full resolution occurring 21 days after the first presentation. Culturing revealed the offending organism to be Acinetobacter.
Discussion:
Most ocular infections are still caused by common organisms such as Staphylococcus. However, atypical bacteria such as Acinetobacter are responsible for a minority of infections. Careful consideration of patient history and clinical signs must be made to differentiate preseptal cellulitis and orbital cellulitis.
Conclusion:
This case emphasizes that clinicians need to be aware of emerging and resistant bacteria in ocular infections. Infections that do not respond to traditional therapy should be treated aggressively with the latest-generation antibiotics. Ocular infections that do not resolve in a timely manner should be cultured for the offending organism and these organisms should be tested for susceptibility to anti-microbial drugs.
Insights
Atypical bacteria like Acinetobacter can cause serious eye infections. Prompt culturing and aggressive treatment with newer antibiotics are crucial for resolving resistant ocular infections.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Microbiology
Background:
- Acinetobacter, a bacterial genus, is increasingly recognized as a significant pathogen.
- Acinetobacter baumannii is the primary species implicated in infections.
- This genus exhibits growing resistance to both older and newer antibiotics.
Observation:
- A 39-year-old woman presented with preseptal cellulitis and conjunctivitis unresponsive to initial antibiotic treatment.
- The infection, initially a hordeolum, progressed despite oral cephalexin and azithromycin.
- The patient was subsequently treated with oral gatifloxacin and topical ciprofloxacin.
Findings:
- Cultures identified Acinetobacter as the causative agent of the ocular infection.
- The patient showed gradual improvement over 10 days, with complete resolution in 21 days.
- This case highlights Acinetobacter as an atypical cause of ocular infections.
Implications:
- Clinicians must consider emerging and antibiotic-resistant bacteria in ocular infections.
- Ocular infections not responding to standard therapy require aggressive treatment with advanced antibiotics.
- Susceptibility testing for antimicrobial drugs is essential for infections caused by unusual organisms.
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