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INNOSC Theranostics and Pharmacological Sciences 2022 Vol. 5 (No. 2) pp: 11-14

INNOSC Theranostics and Pharmacological Sciences

Journal homepage: https://accscience.com/journal/ITPS

CASE REPORT
Non-Hospital-Acquired Pseudomonas aeruginosa Keratitis in a

7-Month-Old Infant

Yanik Keramettin , Hatice Buse Uras *, Celal Yeter 3
2
1
1 Microbiology and Biochemistry Laboratories, Gunesli Erdem Hospital, Bağcılar/İstanbul, 34212, Turkey
2 Department of Psychology, Texas Christian University, Fort Worth, 76109, Texas, United States
3 Gunesli Erdem Hospital, Bağcılar/İstanbul, 34212, Turkey
*Corresponding Author: Hatice Buse Uras, Email: busehaticeuras@gmail.com

Received: March 6, 2023; Accepted: May 17, 2023; Published: May 31, 2023 DOI: https://doi.org/10.36922/itps.401
Copyright: Author(s). This is an open-access article distributed under the terms of the Attribution Non-Commercial 4.0 International
4.0 (CC BY-NC 4.0), which permits all non-commercial use, distribution, and reproduction in any medium, which provided that
the original work is properly cited.

Abstract:

Pseudomonas aeruginosa is one of the important pathogens causing bacterial keratitis with ulceration. In this study, we evaluated
a case of non-hospital-acquired P. aeruginosa keratitis in a 7-month-old infant and its treatment process. The patient who had no
known chronic disease was brought in with complaints of watering and redness in the left eye. The complaint of the eye problems
started 1 month ago after the patient swam in a farm pool. Keratitis was diagnosed according to an ophthalmologic examination in
our clinic. Left corneal scraping cultures were taken for the identification of the pathogen. Moxifloxacin eye drops and ganciclovir
gel were prescribed for 10 days. The corneal haze disappeared after the treatment. Reasons for delay in diagnosis and treatment were
evaluated in our case. We also compared the keratitis between adults and infants. P. aeruginosa keratitis should be considered in the
differential diagnosis, taking into account the presence of resistance to treatment, visual disturbances, lens usage, nasolacrimal duct
obstruction, trauma, and bad hygiene. Congenital nasolacrimal duct obstruction is an important risk factor for infants. Vision loss,
which may happen in adults, cannot be clearly communicated by infants due to their limited communication abilities. P. aeruginosa
should be considered the pathogen causing keratitis in infant patients, particularly when the diagnosed characteristics align with
our case.
Keywords: Keratitis, Pseudomonas aeruginosa, Ulceration, Infant, Infection

1. Background Gram-negative bacillus can survive a broad range
of environmental conditions [4]. Treatment of
Infectious keratitis is a major cause of visual P. aeruginosa keratitis may be difficult because this
impairment and blindness in adults [1]. bacterium can resist antibiotics through intrinsic
Infections are still predominant and are found and acquired mechanisms such as the transfer
in 80 % of patients with ulceration [2]. One of of resistance through interchangeable genetic
the important pathogens of bacterial keratitis elements. A large variety of virulence factors
with ulceration is Pseudomonas aeruginosa contribute to its importance in burn wounds, lung
which is often associated with contaminated infections, and eye infections, including pili,
contact lenses, eye trauma, and hospitalization flagella, lipopolysaccharide, proteases, quorum
history [3]. With various metabolic pathways and sensing, exotoxin A, and exoenzymes secreted by
a vast repertoire of pathogenic mechanisms, this the type III secretion system [5].

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