Alcaligenes xylosoxidans contact lens-related keratitis--a case report and literature review

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.