Bilateral Infectious Keratitis due to Moraxella Nonliquefaciens

Gram-negative diplobacilli Moraxella, commonly found on skin and mucous membranes, rarely cause ocular infections, except for Moraxella nonliquefaciens , associated with severe endophthalmitis. We present the case of a patient with common variable immunodeficiency (CVID) who developed bilateral ulcers due to M. nonliquefaciens without local predisposing factors. This case underscores the relevance of considering M. nonliquefaciens as an important ocular pathogen, even in the absence of local predisposition. This case presents a 42-year-old woman with a history of viral conjunctivitis and common variable immunodeficiency presented with pain and blurred vision in her left eye. She was diagnosed with infectious keratitis caused by M. nonliquefaciens , treated with fortified antibiotic eye drops and cycloplegics. Subsequently, she developed similar symptoms in her right eye, also caused by the same microorganism. After several weeks of treatment, both eyes showed improvement, allowing for continued treatment with topical corticosteroids and antibiotics. Two months later, her visual acuity significantly improved, with clear corneas and paracentral leukomas in both eyes. In conclusion, patients with CVID undergoing intravenous immunoglobulin (IVIG) therapy may develop severe ocular infections, even by uncommon microorganisms such as M. nonliquefaciens . Although IVIG therapy is essential for managing CVID, susceptibility to ocular infections may persist due to deficiencies in local immune response, especially in the tear film. It is crucial to consider this risk when treating patients with CVID for proper management and prevention of ocular complications.