A Case of Corneal Ulcer Caused by Leclercia Adecarboxylata

Kee I1 Lee; Sung Kun Chung; Hyung Bin Hwang

doi:10.3341/jkos.2014.55.6.918

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Lee, Chung, and Hwang: A Case of Corneal Ulcer Caused by Leclercia Adecarboxylata

Case Report

J Korean Ophthalmol Soc 2014;55(6):918-922.

Published online: 30 August 2014

DOI: https://doi.org/10.3341/jkos.2014.55.6.918

A Case of Corneal Ulcer Caused by Leclercia Adecarboxylata

Kee I1 Lee, MD, Sung Kun Chung, MD, PhD, Hyung Bin Hwang, MD

Department of Ophthalmology and Visual Science, The Catholic University of Korea College of Medicine, Seoul, Korea

Address reprint requests to Hyung Bin Hwang, MD, Department of Ophthalmology, The Catholic University of Korea, Yeouido ST. Mary's Hospital, #10 63-ro, Yeongdeungpo-gu, Seoul 150-713, Korea, Tel: 82-2-3779-1243, Fax: 82-2-761-6869, E-mail: leoanzel@catholic.ac.kr

Received 30 August 2013 Revised 10 December 2013 Accepted 30 April 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report a case of corneal ulcer caused by Leclercia adecarboxylata in an immunocompetent patient.

Case summary

A previously healthy 43-year-old female presented with right ocular pain and was referred to our clinic under the impression of corneal abrasion and secondary infection. The patient was treated at a local clinic for 3 days using artificial tears, therapeutic contact lens, topical antibiotics, and anti-inflammatory eye drops but showed no improvement. Gram staining, bac-terial and fungal cultures and antibiotic sensitivity test were performed from a corneal scrape. The cultures revealed growth of Leclercia adecarboxylata. The patient was treated with moxifloxacin and ofloxacin eye drops. After 2 weeks of treatment, the in-fection resolved without remaining scars.

Conclusions

Reportedly, Leclercia adecarboxylata affects humans only as an opportunistic pathogen or part of polymicrobial infections. However, in the present case, Leclercia adecarboxylata was isolated as a single pathogen in an immunocompetent patient which is the first clinical report of this microorganism found in an ocular sample. Therefore, if antibiotic-susceptible gram-negative bacilli are found in op-thalmologic samples, the above bacteria should be considerd in the diagnosis.

Keywords: Corneal ulcer, Gram-negative bacilli, Leclercia adecarboxylata

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Figure 1.

(A) Anterior segment photograph at the first oph-thalmic examination showing a corneal ulcer with deep stromal infiltrations and linear hypopyon. (B) Corneal ulcer with de-creased stromal infiltration and remaining hypopyon on the 2nd day of antibacterial treatment. (C) Nearly regressed corneal ul-cer on the 7th day of antibacterial treatment.

Figure 2.

(A) Anterior segment photograph (Fluorescein dye stained) on the 3rd day after starting anti-bacterial treatment; better marginated corneal ulcer with decreased stromal infiltration. (B) Anterior segment photograph (Fluorescein dye stained) on the 5th day showing decreased epithelial defects with remnant bacterial collections at the inferior cornea.

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