unusual bacteroides distasonis related corneal ulcer: questions to be answered

ABSTRACT

We herein present an unusual case of Bacteroides distasonis related corneal ulcer. A 70-year-old male farmer presented with decreased vision, pain and redness in the left eye that had persisted for 1 week. Ophthalmic examination was highly suggestive of keratitis with corneal ulcer. Empirical fortified antibiotic therapy with fungal coverage was started after corneal swab and microbiological sampling. Since two attempts at pathogen detection were unrevealing and there was no good sign of healing, third attempt was performed with the presence of attending microbiologist. This time, sampling for anaerobic culturing was also performed, which detected B. distasonis as the causative agent. The patient disagreed to be followed as inpatient at this point. Despite pathogen-targeted metranidazole treatment, severe corneal scarring with prominent vascularization was observed forty days after initial presentation. To the authors' knowledge, this is the first reported case of B. distasonis related corneal ulcer with a detailed clinical course. In conclusion, it is very crucial to be in close collaboration with the microbiologists to isolate unusual corneal pathogens. Corneal ulcers related with unusual bacterias should be followed up closely with hospitalization