Capnocytophaga keratitis

Ophthalmology. 2000 Aug;107(8):1503-6. doi: 10.1016/s0161-6420(00)00227-x.

Abstract

Purpose: To review the clinical course, treatment, and visual outcomes of keratitis caused by the gram negative rod CAPNOCYTOPHAGA:

Design: Retrospective, noncomparative case series.

Participants: Ten patients with culture-proven unilateral CAPNOCYTOPHAGA: keratitis examined at the Bascom Palmer Eye Institute between January 1, 1989, and December 31, 1998.

Intervention: All patients underwent standard diagnostic microbiologic evaluation, and topical antimicrobial therapy was instituted. A penetrating keratoplasty or enucleation was performed in some patients.

Main outcome measures: The changes in visual acuity and clinical response to antimicrobial therapy.

Results: Predisposing factors were present in all patients. Cultures identified CAPNOCYTOPHAGA: species at a mean of 7.5 days. Initial topical treatment consisted of an aminoglycoside and vancomycin in four patients, a quinolone or aminoglycoside alone in two patients each, and ofloxacin with vancomycin or tobramycin with ceftazidime in one patient each. After the microbiologic identification of CAPNOCYTOPHAGA:, treatment in four patients was changed to intensive, topical clindamycin. Five of the 10 eyes were medically cured (3 of these eyes underwent penetrating keratoplasty for corneal scarring), and 5 eyes required enucleation. The indications for enucleation included persistent infection with development of endophthalmitis or blind, painful eye. Five of the 10 eyes achieved 20/80 or better final visual acuity. Four of these five eyes were treated with topical clindamycin.

Conclusions: Important factors in achieving a good visual outcome in CAPNOCYTOPHAGA: keratitis include early microbiologic identification and intensive therapy with topical clindamycin. CAPNOCYTOPHAGA: should be included in the differential diagnosis of bacterial keratitis in patients with suggestive predisposing factors or with protracted keratitis unresponsive to treatment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Capnocytophaga / isolation & purification*
  • Eye Enucleation
  • Eye Infections, Bacterial / diagnosis
  • Eye Infections, Bacterial / microbiology*
  • Eye Infections, Bacterial / therapy
  • Female
  • Gram-Negative Bacterial Infections / diagnosis
  • Gram-Negative Bacterial Infections / microbiology*
  • Gram-Negative Bacterial Infections / therapy
  • Humans
  • Keratitis / diagnosis
  • Keratitis / microbiology*
  • Keratitis / therapy
  • Keratoplasty, Penetrating
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Visual Acuity

Substances

  • Anti-Bacterial Agents