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Moraxella Keratitis: A Case Series
Sarah E Kenny1, Madeleine Puig, Ricardo Salinas
1Department of Ophthalmology, University of Texas Health San Antonio, San Antonio, TX.
Objective:
To report the ocular and systemic risk factors, clinical manifestations, and management outcomes of Moraxella keratitis.
Methods:
This retrospective study included patients with culture-proven Moraxella keratitis in South Texas between 2012 and 2018. Clinical data including demographics, ocular and systemic risk factors, clinical presentation, speciation, and treatment course were collected.
Results:
Fourteen eyes of 14 patients had culture-proven Moraxella keratitis which made up 8.1% of cases of culture-proven bacterial keratitis in the period studied. These included 10 men and 4 women with a mean age of 52.7±11.3 years. Ten patients (71.4%) had different ocular risk factors such as ocular trauma, corneal foreign body, contact lens use, preceding viral keratitis, neurotrophic cornea, and recent corneal transplant on topical steroids. Systemic risk factors included diabetes mellitus, systemic immunosuppressive therapy, cancer chemotherapy, and AIDS. There was no specific clinical manifestation. The size of stromal infiltration on initial presentation varied among the cases, with 71.4% stromal infiltrations of 4 mm or less. The patients were managed with fortified tobramycin, fortified vancomycin, and moxifloxacin eye drops. No eyes required surgical intervention during treatment for the active infection, except for one eye with pre-existing no light perception that was enucleated because of chronic pain.
Conclusions:
Moraxella keratitis is a less frequent form of bacterial keratitis that appears more prevalent in patients with previous ocular conditions. Early diagnosis of this infection and medical treatment with a conventional corneal ulcer regimen can result in good clinical outcomes without the need for a surgical intervention.
Insights
Moraxella keratitis is a rare bacterial eye infection often seen in patients with pre-existing ocular conditions. Prompt medical treatment typically leads to good outcomes without surgery.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Microbiology
Background:
- Moraxella keratitis is an uncommon cause of bacterial keratitis.
- Understanding its risk factors and clinical course is crucial for effective management.
Purpose of the Study:
- To investigate the ocular and systemic risk factors associated with Moraxella keratitis.
- To describe the clinical manifestations and treatment outcomes for this condition.
Main Methods:
- Retrospective study of patients with culture-proven Moraxella keratitis.
- Data collected on demographics, risk factors, clinical presentation, and treatment.
Main Results:
- Moraxella keratitis accounted for 8.1% of bacterial keratitis cases.
- Ocular risk factors (trauma, contact lens use, etc.) and systemic conditions (diabetes, immunosuppression) were common.
- Most stromal infiltrations were small, and medical management was successful in most cases.
Conclusions:
- Moraxella keratitis is more common in individuals with prior ocular issues.
- Early diagnosis and medical treatment yield favorable outcomes, often avoiding surgery.
