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Alcaligenes xylosoxidans Contact Lens–Related Keratitis—A Case Report and Literature Review

Ahmed, Abdalla Awadalla M.D.; Pineda, Roberto M.D.

doi: 10.1097/ICL.0b013e318235893a
Case Report

Background: Alcaligenes xylosoxidans can result in opportunistic infections in patients who are immunocompromised. Alcaligenes xylosoxidans keratitis is a rare infection, almost always occurring in a compromised cornea. Few reported cases have occurred as contact lens–induced keratitis. The purposes of this report are to report a case of A. xylosoxidans keratitis in an immunocompetent contact lens wearer (2-week disposable) and to review the related literature.

Methods: A 30-year-old man developed acute keratitis in the right eye. He was a 2-week disposable contact lens wearer. He did not report any ocular or systemic illness. Corneal scraping, contact lens, and conjunctiva cultures were performed.

Results: 0.5% moxifloxacin eye drops were started hourly with quick recovery and healing of the ulcer and epithelial defect noted within a few days. Culture of the contact lens was positive for A. xylosoxidans. The organism was sensitive to penicillins, third-generation cephalosporins, and fluoroquinolones but resistant to aminoglycosides.

Conclusions: Alcaligenes xylosoxidans is a potential pathogen in compromised corneas. It has high susceptibility to extended-spectrum penicillins and current generations of fluoroquinolones but rarely responds to aminoglycosides. Alcaligenes xylosoxidans should be considered in the differential diagnosis of contact lens–induced keratitis.

From the Makkah Eye Complex (A.A.A.), Khartoum, Sudan; and Massachusetts Eye and Ear Infirmary (R.P.), Harvard Medical School, Boston, MA.

The authors have no funding or conflicts of interest to disclose.

Address correspondence and reprint requests to Abdalla Awadalla Ahmed, M.D., Makkah Eye Complex, P.O. Box 12368, Khartoum, Sudan; e-mail:

Accepted September 4, 2010.

© 2011 Lippincott Williams & Wilkins, Inc.