Ocular Mycobacterium haemophilum infection originating in the cornea: a case report
Abstract Background Mycobacterium haemophilum is a slow-growing non-chromogenic nontuberculous Mycobacterium species that can cause skin infection or arthritis in an immunocompromised population or in children. Primary infection of the healthy adult cornea is rare. The special requirements for cultu...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12879-023-08094-2 |
| _version_ | 1797865480453619712 |
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| author | Yu-Qiang Zhang Ting-Ting Xu Fu-Yan Wang Shuang Wang Jun Cheng |
| author_facet | Yu-Qiang Zhang Ting-Ting Xu Fu-Yan Wang Shuang Wang Jun Cheng |
| author_sort | Yu-Qiang Zhang |
| collection | DOAJ |
| description | Abstract Background Mycobacterium haemophilum is a slow-growing non-chromogenic nontuberculous Mycobacterium species that can cause skin infection or arthritis in an immunocompromised population or in children. Primary infection of the healthy adult cornea is rare. The special requirements for culture make this pathogen difficult to diagnose. The study aims to report the clinical manifestation and treatment process of corneal infection and notify the awareness of M. Haemophilus keratitis among clinicians. This is the first case report of primary M. haemophilum infection in the cornea of healthy adults reported in the literature. Case presentation A 53-year-old healthy goldminer presented with left eye redness and a history of vision loss for four months. The patient was misdiagnosed with herpes simplex keratitis until M. haemophilum was detected using high-throughput sequencing. Penetrating keratoplasty was performed, and a large number of mycobacteria were detected by Ziehl-Neelsen staining of the infected tissue. Three months later, the patient developed conjunctival and eyelid skin infections that manifested as caseous necrosis of the conjunctiva and skin nodules. After excision and debridement of the conjunctival lesions and systemic antituberculosis drug treatment for 10 months, the patient was cured. Conclusion M. haemophilum could cause primary corneal infection in healthy adults, which is an infrequent or rare infection. Owing to the need for special bacterial culture conditions, conventional culture methods do not provide positive results. High-throughput sequencing can rapidly identify the presence of bacteria, which aids in early diagnosis and timely treatment. Prompt surgical intervention is an effective treatment option for severe keratitis. Long-term systemic antimicrobial therapy is crucial. |
| first_indexed | 2024-04-09T23:08:30Z |
| format | Article |
| id | doaj.art-82adaa0bdd0a4288b433bf52c4378966 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-04-09T23:08:30Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-82adaa0bdd0a4288b433bf52c43789662023-03-22T10:32:11ZengBMCBMC Infectious Diseases1471-23342023-03-012311610.1186/s12879-023-08094-2Ocular Mycobacterium haemophilum infection originating in the cornea: a case reportYu-Qiang Zhang0Ting-Ting Xu1Fu-Yan Wang2Shuang Wang3Jun Cheng4Qingdao UniversityEye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical UniversityEye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical UniversityEye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical UniversityEye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical UniversityAbstract Background Mycobacterium haemophilum is a slow-growing non-chromogenic nontuberculous Mycobacterium species that can cause skin infection or arthritis in an immunocompromised population or in children. Primary infection of the healthy adult cornea is rare. The special requirements for culture make this pathogen difficult to diagnose. The study aims to report the clinical manifestation and treatment process of corneal infection and notify the awareness of M. Haemophilus keratitis among clinicians. This is the first case report of primary M. haemophilum infection in the cornea of healthy adults reported in the literature. Case presentation A 53-year-old healthy goldminer presented with left eye redness and a history of vision loss for four months. The patient was misdiagnosed with herpes simplex keratitis until M. haemophilum was detected using high-throughput sequencing. Penetrating keratoplasty was performed, and a large number of mycobacteria were detected by Ziehl-Neelsen staining of the infected tissue. Three months later, the patient developed conjunctival and eyelid skin infections that manifested as caseous necrosis of the conjunctiva and skin nodules. After excision and debridement of the conjunctival lesions and systemic antituberculosis drug treatment for 10 months, the patient was cured. Conclusion M. haemophilum could cause primary corneal infection in healthy adults, which is an infrequent or rare infection. Owing to the need for special bacterial culture conditions, conventional culture methods do not provide positive results. High-throughput sequencing can rapidly identify the presence of bacteria, which aids in early diagnosis and timely treatment. Prompt surgical intervention is an effective treatment option for severe keratitis. Long-term systemic antimicrobial therapy is crucial.https://doi.org/10.1186/s12879-023-08094-2Mycobacterium haemophilumKeratitisConjunctivitisHigh-throughput sequencingCase report |
| spellingShingle | Yu-Qiang Zhang Ting-Ting Xu Fu-Yan Wang Shuang Wang Jun Cheng Ocular Mycobacterium haemophilum infection originating in the cornea: a case report BMC Infectious Diseases Mycobacterium haemophilum Keratitis Conjunctivitis High-throughput sequencing Case report |
| title | Ocular Mycobacterium haemophilum infection originating in the cornea: a case report |
| title_full | Ocular Mycobacterium haemophilum infection originating in the cornea: a case report |
| title_fullStr | Ocular Mycobacterium haemophilum infection originating in the cornea: a case report |
| title_full_unstemmed | Ocular Mycobacterium haemophilum infection originating in the cornea: a case report |
| title_short | Ocular Mycobacterium haemophilum infection originating in the cornea: a case report |
| title_sort | ocular mycobacterium haemophilum infection originating in the cornea a case report |
| topic | Mycobacterium haemophilum Keratitis Conjunctivitis High-throughput sequencing Case report |
| url | https://doi.org/10.1186/s12879-023-08094-2 |
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