Recalcitrant Infectious Keratitis in DOCK8 Immunodeficiency Syndrome

An 11-year-old girl with DOCK8 (dedicator of cytokinesis 8) immunodeficiency syndrome developed viral keratitis and subsequently developed methicillin-resistant Staphylococcus aureus-related bacterial keratitis as a superadded infection. Despite prompt antiviral and antibiotic therapy, the course of healing was slow, but ultimately the infections resolved and visual acuity improved. This case highlights the rare presentation and prolonged course of viral and bacterial keratitis in DOCK8 deficiency, emphasizing the need for early suspicion and aggressive management of infections.