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Abstract:
We present a patient with a corneal ulcer due to Listeria monocytogenes, which has not previously been considered to be a feature of human listeriosis. The ulcer responded to topical and subconjunctival gentamicin and cephaloridine. Subsequent management was complicated by the development of a fibrinous pupillary membrane leading to pupillary block requiring iridotomy and later vitrectomy with trabeculectomy. Listeria monocytogenes may be confused with diphtheroid contaminants seen in corneal ulcer scrapings and is probably underreported as a cause for microbial keratitis.
Insights
Listeria monocytogenes can cause corneal ulcers, a rare condition in humans. Prompt treatment with antibiotics and surgical interventions managed this case of microbial keratitis.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Microbiology
Background:
- Listeriosis is typically associated with systemic infections, not ocular manifestations.
- Corneal ulcers are commonly caused by bacteria, fungi, or viruses, but Listeria monocytogenes is rarely implicated.
Observation:
- A patient presented with a corneal ulcer initially suspected to be caused by a common pathogen.
- Microscopic examination of corneal scrapings revealed Listeria monocytogenes, often mistaken for diphtheroids.
Findings:
- The corneal ulcer showed improvement with topical and subconjunctival gentamicin and cephaloridine.
- The patient developed complications including a fibrinous pupillary membrane, leading to pupillary block glaucoma.
Implications:
- Listeria monocytogenes should be considered in the differential diagnosis of microbial keratitis, even in the absence of systemic symptoms.
- This case highlights the potential for underreporting Listeria monocytogenes as a cause of severe microbial keratitis.