A Case of Bacterial Keratitis and Endophthalmitis Caused by Two Types of Antibiotic-resistant Bacteria
10.3341/jkos.2025.66.1.75
- Author:
Hyun Jung KIM
1
;
EunAh KIM
;
Chan-Ho CHO
Author Information
1. Department of Ophthalmology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
- Publication Type:Case Report
- From:Journal of the Korean Ophthalmological Society
2025;66(1):75-80
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Purpose:To report a case of infectious keratitis and endophthalmitis caused by two types of antibiotic-resistant bacteria.Case summary: A 62-year-old female patient presented to our clinic with left ocular pain for 2 weeks and was diagnosed with herpetic keratitis and anterior uveitis. At the initial presentation, slit lamp biomicroscopy revealed round stromal infiltration and edema in the paracentral part of the cornea, a 2 × 2-mm epithelial defect, and hypopyon. Ocular ultrasonography showed vitreous opacities. She was empirically treated with topical 0.5% moxifloxacin, 2% tobramycin, and 5% ceftazidime administered hourly. Intravitreal vancomycin/ceftazidime administration was performed on days 2 and 7 following treatment. Corneal culture revealed extended-spectrum β-lactamase-producing Klebsiella pneumoniae and methicillin-resistant Staphylococcus aureus on day 4 after treatment. Consequently, 2% tobramycin was replaced with 1% vancomycin. The corneal lesion gradually improved and healed completely with a residual corneal opacity at 4 weeks after treatment.
Conclusions:Polymicrobial bacterial keratitis caused by antibiotic-resistant bacteria represents a treatment challenge. Therefore, culture is essential to obtain microbiological evidence and guide appropriate antibiotic selection.
