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Corneal ulceration secondary to intestinal Shigella sonnei
Abstract:
A 34-month-old boy had a corneal ulcer due to Shigella sonnei. To my knowledge, this is the first documented case reported where the same organism was recovered from the stool. One other case of S sonnei and two cases of S flexneri corneal ulcers have appeared in the literature. All cases have been in young black boys between the ages of 23 months and 6 years. The exact pathogenesis remains unclear, but direct fecalocular inoculation into a preexisting epithelial defect, a probable herpetic dendrite in this case, is most likely.
Insights
This case report details a rare corneal ulcer in a young boy caused by Shigella sonnei, with the same bacteria found in his stool. This suggests a potential fecal-ocular route for infection in pediatric corneal ulcers.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Microbiology
Background:
- Corneal ulcers are serious eye infections that can lead to vision loss.
- Shigella species are known bacterial pathogens causing gastroenteritis.
Observation:
- A 34-month-old boy presented with a corneal ulcer.
- Shigella sonnei was identified as the causative agent of the corneal ulcer.
- Shigella sonnei was also isolated from the patient's stool sample.
Findings:
- This is the first reported case of a Shigella sonnei corneal ulcer where the organism was also recovered from stool.
- Previous literature includes only a few cases of Shigella corneal ulcers, primarily in young children.
- The patient had a pre-existing corneal epithelial defect, possibly a herpetic dendrite.
Implications:
- The findings suggest direct fecal-ocular inoculation as a likely route of infection for Shigella corneal ulcers in children.
- This highlights the importance of considering fecal-oral transmission in pediatric eye infections, especially in cases with pre-existing corneal defects.
- Further research is needed to understand the pathogenesis and risk factors associated with Shigella-related corneal infections.