Case Report: Burkholderia pseudomallei–Caused Sclerokeratitis

Onsiri Thanathanee Department of Ophthalmology, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand

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Korawin Charoensuk Department of Ophthalmology, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand

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Yuwarat Uthairat Department of Ophthalmology, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand

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Suparat Laohapitakvorn Department of Ophthalmology, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand

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Orapin Anutarapongpan Department of Ophthalmology, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand

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Olan Suwan-apichon Department of Ophthalmology, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand

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ABSTRACT.

This report is on a 45-year-old male patient without underlying disease who presented with a Burkholderia pseudomallei–caused keratoscleritis in his right eye. Slit-lamp examination revealed multiple, indistinct corneal infiltrations with subconjunctival/scleral abscesses. Corneal tissue culture was positive for B. pseudomallei and confirmed by mass spectrometry. The patient was treated with fortified ceftazidime, fortified gentamicin eyedrops, and intravenous ceftazidime injection. Penetrating keratoplasty, including intracameral ceftazidime injections, was undertaken due to corneal lesion worsening. Scleral debridement with subconjunctival ceftazidime injections were undertaken due to the progression of the scleral abscess. After 2 months, the corneal and scleral lesions were inactive, and the systemic and topical antibiotics were tapered. This is the first case report of B. pseudomallei–caused keratoscleritis with photography. The patient was seen in an endemic geographical area with multiple corneal infiltrations and subconjunctival/scleral abscess. Systemic and topical antibiotics accompanied with surgery should be considered.

Author Notes

Address correspondence to Onsiri Thanathanee, Department of Ophthalmology, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen 40002, Thailand. E-mail: onsirit@yahoo.com

Authors’ addresses: Onsiri Thanathanee, Korawin Charoensuk, Yuwarat Uthairat, Suparat Laohapitakvorn, Orapin Anutarapongpan, and Olan Suwan-apichon, Department of Ophthalmology, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand, E-mails: onsirit@yahoo.com, korawin.wn@gmail.com, y.uthairat@gmail.com, lecsuparat@gmail.com, orapin_159@yahoo.com, and osuwanapichon@hotmail.com.

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