Case Report: Burkholderia pseudomallei-Caused Sclerokeratitis

This report is on a 45-year-old male patient without underlying disease who presented with a Burkholderia pseudomallei-caused keratoscleritis in his right eye. Slit-lamp examination revealed multiple, indistinct corneal infiltrations with subconjunctival/scleral abscesses. Corneal tissue culture was positive for B. pseudomallei and confirmed by mass spectrometry. The patient was treated with fortified ceftazidime, fortified gentamicin eyedrops, and intravenous ceftazidime injection. Penetrating keratoplasty, including intracameral ceftazidime injections, was undertaken due to corneal lesion worsening. Scleral debridement with subconjunctival ceftazidime injections were undertaken due to the progression of the scleral abscess. After 2 months, the corneal and scleral lesions were inactive, and the systemic and topical antibiotics were tapered. This is the first case report of B. pseudomallei-caused keratoscleritis with photography. The patient was seen in an endemic geographical area with multiple corneal infiltrations and subconjunctival/scleral abscess. Systemic and topical antibiotics accompanied with surgery should be considered.