Atopic keratoconjunctivitis complicated by Kocuria koreensis keratitis: the first case

• Published in: Allergy, asthma, and clinical immunology asthma, and clinical immunology, 2017-01, Vol.13 (1), p.6, Article 6
• Main Authors: Inada, Noriko, Shoji, Jun, Yamagami, Satoru
• Format: Article
• Language: English
• Subjects: Care and treatment; Case Report; Complications and side effects; Conjunctivitis; Keratitis; Risk factors
• ISSN: 1710-1484; 1710-1492; 1710-1492
• DOI: 10.1186/s13223-017-0178-9

Patients with atopic dermatitis have a predisposition to and a virus infection. The treatment of atopic diseases with steroid and immunosuppressive agents induces opportunistic infection. However, there is a concern regarding visual prognosis in patients with atopic keratoconjunctivitis (AKC) complicated with infectious keratitis. We report an unusual case of an atopic shield ulcer with keratitis. A 51-year-old Japanese man presented with a 14-day history of eye pain and visual loss in his left eye. At the initial examination, a shield ulcer was observed in the upper-central cornea of the left eye, and the conjunctiva in both eyes had a velvety appearance due to papillary formation, as well as hyperemia and swelling in the palpebral area. The shield ulcer showed white stromal opacification in the marginal zone with a coral-like appearance. Samples were obtained by corneal scraping, and sp. was identified by microbiological examination including culture and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. The 16S rRNA gene sequence analysis was performed using isolated Kocuria strain from the patient. The obtained DNA sequence showed 99% homology with The combination of corneal scraping and instillation of cefmenoxime antibiotic ophthalmic solution was considered useful for the treatment of keratitis. Clinicians should be aware of keratitis as a corneal complication of AKC, and that rapid diagnosis of keratitis may improve visual prognosis.