Corneal infection byPseudomonas stutzerifollowing excision of trigeminal nerve schwannoma

Abstract

SUMMARYA 25-year-old woman underwent intracranial surgery for trigeminal nerve schwannoma (TGNS) with persistent left-sided facial hypoaesthesia. Two months later, she developed a central corneal ulceration. Scraping of the corneal lesion revealed Gram-negative bacilli. Genus level identification was achieved using standard techniques and species level identification, revealing Pseudomonas stutzeri, was aided by a VITEK 2 compact system. Broadspectrum fortified antibiotics were initially started followed by species-sensitive fortified antibiotics. Ocular surface toxicity developed a week later; this was managed with a non-fortified antibiotic. The epithelial defect healed in 3 weeks with subsequent corneal scar formation. Visual rehabilitation was achieved with deep anterior lamellar keratoplasty. Six months following surgery, the patient had a visual acuity of 20/40 with −1.25 170°−0.5 refractive correction and a clear graft. This case report, for the first time, highlights P. stutzeri, an aetiological agent of corneal ulcer following excision of TGNS and its successful management. BACKGROUND

Chronic Endophthalmitis Caused by <b><i>Pseudomonas stutzeri</i></b>

“…In humans, P. stutzeri causes wound infections, postoperative infections, and peritonitis following dialysis [3-5]. In the eye, it has been identified in rare cases of endophthalmitis and corneal ulcers [6, 7].…”

Incidence, Clinical Profile, and Management of Keratitis Caused by Uncommon Species of Pseudomonas at a Tertiary Eye Care Center

“…9 In this study, Pseudomonas putida, Pseudomonas stutzeri, Pseudomonas mendocina, Pseudomonas oryzihabitans, and Pseudomonas alcaligenes were the unusual species isolated in patients with keratitis. Very few reports of P. putida causing keratitis have been documented in the past 8,10 ; P. stutzeri has been reported in a few case studies as a postoperative infection, 11,12 but detailed clinical studies have yet to be documented. In this study, we present a series of 30 patients with keratitis caused by uncommon species of Pseudomonas presenting to a tertiary eye care center.…”