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Fulminant Sphingomonas paucimobilis keratitis: case study and review of literature
Rinky Agarwal1, Meghal Gagrani2, Asmita Mahajan2
1Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, Delhi, India rinky.1990@gmail.com.
Abstract:
Sphingomonas paucimobilis is a low-virulence gram-negative bacillus known to cause various ocular infections such as endophthalmitis, panophthalmitis and keratitis that are usually associated with an underlying risk factor such as peri-partum or postpartum phase, cataract surgery, contact lens use, neurotrophic keratopathy or ocular trauma. We report a case of spontaneously occurring perforated corneal ulcer caused by the organism in a young man managed by penetrating keratoplasty. The course was followed by endophthalmitis with graft infection culminating in phthisis bulbi despite aggressive medical and surgical management. Along with reporting this case, we also present a review of literature on ocular infections caused by the same organism.
Insights
Sphingomonas paucimobilis, a gram-negative bacillus, can cause severe ocular infections. This case highlights a rare spontaneous corneal ulcer leading to endophthalmitis and phthisis bulbi despite treatment.
Area of Science:
- Ophthalmology
- Microbiology
Background:
- Sphingomonas paucimobilis is a gram-negative bacillus implicated in diverse ocular infections.
- Risk factors include postpartum status, cataract surgery, contact lens wear, neurotrophic keratopathy, and ocular trauma.
Observation:
- A young man presented with a spontaneously perforated corneal ulcer caused by Sphingomonas paucimobilis.
- Initial management involved penetrating keratoplasty.
Findings:
- The patient developed post-keratoplasty endophthalmitis with graft infection.
- Despite aggressive medical and surgical interventions, the infection progressed to phthisis bulbi.
Implications:
- This case underscores the potential for severe outcomes from Sphingomonas paucimobilis ocular infections, even with prompt management.
- A review of literature on ocular infections caused by this organism is presented.
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