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Bilateral Infectious Keratitis due to Moraxella Nonliquefaciens
Jorge Salvo Jiménez1, Alfredo Vega Estrada, Ezequiel Campos Mollo
1Department of Ophthalmology, Virgen de los Lirios Hospital, Alcoy (Alicante), Spain .
Eye & Contact Lens
|August 5, 2025
Summary
Common variable immunodeficiency (CVID) patients on IVIG therapy can develop severe ocular infections from Moraxella nonliquefaciens. This highlights the need for vigilance against uncommon pathogens, even without local risk factors.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Immunology
Background:
- Moraxella species are Gram-negative diplobacilli typically found on skin and mucous membranes.
- Ocular infections are rare but Moraxella nonliquefaciens is linked to severe endophthalmitis.
- Common variable immunodeficiency (CVID) impairs immune function, potentially increasing infection susceptibility.
Purpose of the Study:
- To report a case of bilateral M. nonliquefaciens keratitis in a CVID patient.
- To emphasize M. nonliquefaciens as a potential ocular pathogen in immunocompromised individuals.
- To discuss the implications for managing CVID patients receiving intravenous immunoglobulin (IVIG) therapy.
Main Methods:
- Case report of a 42-year-old female patient with CVID.
- Clinical presentation of bilateral infectious keratitis.
- Microbiological diagnosis of Moraxella nonliquefaciens.
- Treatment with fortified antibiotics, cycloplegics, topical corticosteroids, and IVIG therapy.
Main Results:
- The patient developed bilateral M. nonliquefaciens keratitis despite no local predisposing factors.
- Successful treatment led to significant visual acuity improvement and corneal healing with residual leukomas.
- The case demonstrates the potential for severe ocular infections in CVID patients on IVIG.
Conclusions:
- Patients with CVID receiving IVIG are at risk for severe ocular infections, including those caused by uncommon pathogens like M. nonliquefaciens.
- Deficiencies in local immune response, particularly the tear film, may contribute to persistent susceptibility.
- Ophthalmologists should consider M. nonliquefaciens in CVID patients presenting with ocular infections, irrespective of local risk factors, for optimal management and prevention.
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