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Park, Lee, and Lee: Hafnia Alvei Keratitis after Using a Therapeutic Contact Lens in a Patient with Graft-Versus-Host Disease
Case Report
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(8): 1163-1166.

Published online: 17 August 2012

DOI: https://doi.org/10.3341/jkos.2012.53.8.1163

Hafnia Alvei Keratitis after Using a Therapeutic Contact Lens in a Patient with Graft-Versus-Host Disease

Sang Uk Park, MD, Seung Jun Lee, MD, Seung Chan Lee, MD

Department of Ophthalmology, Kangwon National University School of Medicine, Chuncheon, Korea.

Address reprint requests to Seung Chan Lee, MD. Department of Ophthalmology, Kangwon National University Hospital, #156 Baekryeong-ro, Chuncheon 200-722, Korea. Tel: 82-33-258-2443, Fax: 82-33-258-2191, uncontrolled@medimail.co.kr

Received 10 December 2011       Accepted 2 June 2012

Copyright © 2012 The Korean Ophthalmological Society

Abstract

Purpose

To report a case of bacterial keratitis caused by Hafnia alvei after using a contact lens in a patient with graft-versus-host disease.

Case summary

A 47-year-old male patient presented with a corneal ulcer. The patient had been wearing a therapeutic contact lens for a month because of severe dry eye syndrome and filament removal due to filamentary keratitis. The patient had been taking moxifloxacin to prevent infection, but had not for the previous 7 days. The corneal ulcer occurred at the 11 o'clock direction in the peripheral cornea accompanied by corneal epithelial defect and stromal infiltration. The corneal scraping and culture yielded Hafnia alvei, which is susceptible to ceftazidime, levofloxacin and moxifloxacin. There was no systemic signs or symptoms to suspect systemic infection. After treatment with a topical antibiotic agent, the patient's eye condition improved with only mild corneal opacity remaining.

Conclusions

Hafnia alvei infection rarely occurs in humans but should be considered as a potential causal pathogen in immunosuppressed patients.

Keywords: Contact lens, Graft-versus-host disease, Hafnia alvei

Figures and Tables

Figure 1
The slit-lamp photograph revealed corneal punctate epithelial erosions and filaments. Filament removal was done and therapeutic contact lens was applied.
jkos-53-1163-g001
Figure 2
The slit-lamp photograph at two months after contact lens application revealed a 1.0 mm × 1.0 mm-sized round corneal epithelial defect with stromal infiltration at the 11 o'clock direction.
jkos-53-1163-g002
Figure 3
Seven days after treatment with susceptible topical antibiotics, the corneal lesion showed complete epithelialization with faint corneal opacity.
jkos-53-1163-g003

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