Bilateral corneal ulcer due to K. oxytoca: A case report

Bacterial keratitis is one of the leading causes of monocular blindness worldwide. The following case describes the case of a patient with bilateral bacterial keratitis caused by Klebsiella oxytoca, a gram-negative bacterium often overlooked in cases of bacterial infectious keratitis. The patient is a 20-year-old man with a past medical history of allergic keratoconjunctivitis and keratoconus who developed an epithelial defect following improper handling of his contact lenses. Initially, the patient was managed with ocular lubricants. However, he experienced a rapid and aggressive deterioration in visual acuity, with an expansion of the epithelial defect and the appearance of bilateral stromal infiltrates. Due to the poor response to empirical antimicrobial therapy, cultures were obtained from the contact lenses, which identified the presence of K. oxytoca as the causative agent. The antibiogram revealed resistance to widely used antibiotics such as ciprofloxacin. Following these results, targeted antimicrobial therapy was initiated, leading to significant clinical improvement and substantial anatomical and visual recovery. This case underscores the importance of recognizing the potential aggressiveness of K. oxytoca in immunocompetent patients, which can cause severe ocular infections, particularly in individuals with risk factors such as contact lens wear. It also highlights the critical need for microbiological cultures and antibiograms to guide effective therapy, given the variable resistance patterns of this microorganism.