Multi-drug resistant post corneal repair klebsiella oxytoca’s keratitisa

Abstract

Background: Bacterial keratitis can threaten vision through permanent corneal scarring and even perforation, resulting in loss of the eye. Klebsiella oxytoca is resistant to several antibiotics because it produces extended-spectrum β-lactamase encapsulated with polysaccharide. Thus, this article is aimed at reporting a rare case of Klebsiella oxytoca-induced keratitis in Jimma University Medical Centre, Jimma, Ethiopia. Case Presentation: TA 25-year-old female patient presented with photophobia, redness, and purulent discharge from the right eye. She had matted cilia of the eyelid, conjunctiva injection, corneal ulcer, and deep fibrinous anterior chamber reaction. She had light perception (LP) visual acuity for the same eye and it was firm when examined digitally. The cornea-scleral repair was performed one month earlier, due to open globe injury. The patient had taken empirical fortified antibiotics before the identification of the specific pathogen. Culture and drug sensitivity test was performed in order to identify the aetiology. The result of the test revealed that the identified pathogen was multi-drug-resistant Klebsiella oxytoca. Based on this result and drug availability, high dose topical fluoroquinolones eye drops (Ciprofloxacin eye drop 0.3% and Ofloxacin 0.3%) were given. Besides, dexamethasone 0.1% eye drop was added to the aforementioned antibiotics. After four months of treatment, the visual outcome was changed from LP to hand motion. Conclusion: A rare case of multi-drug resistant Klebsiella oxytoca induced keratitis which was isolated in a biochemical test was successfully treated with a high dose of fluoroquinolones.