title: Recurrent Alcaligenes xylosoxidans keratitis.
abstract: OBJECTIVE
  To describe a case of postkeratoplasty recurrent Alcaligenes xylosoxidans keratitis.
  
  
  METHODS
  A 33-year-old man with a history of penetrating keratoplasty developed corneal infiltrate with intact epithelium and then was treated with broad-spectrum antibiotics. Corneal scraping was taken for microbiologic study.
  
  
  RESULTS
  The culture result identified A. xylosoxidans, sensitive to piperacillin and ceftazidime. There were 3 recurrent episodes within 2 months after each apparent resolution achieved after the instillation of topical piperacillin (10 mg/mL). During the fourth attack, the lesion responded poorly to piperacillin and ceftazidime (25 mg/mL), so therapeutic penetrating keratoplasty was performed to eradicate the recalcitrant infection.
  
  
  CONCLUSIONS
  A. xylosoxidans has probably been underreported as a cause of ocular infection. It does not respond to conventional antibiotic therapy and may be difficult to eradicate. Therapeutic penetrating keratoplasty might be necessary if medical treatment fails.
authors.affiliation: Department of Ophthalmology, Chang Gung Memorial Hospital, Taipei, Taiwan, Republic of China.
authors.forename: Zei-Lun
authors.initials: ZL
authors.lastname: Huang
authors.forename: Yeong-Fong
authors.initials: YF
authors.lastname: Chen
authors.forename: Shu-Wen
authors.initials: SW
authors.lastname: Chang
authors.forename: Ken-Kuo
authors.initials: KK
authors.lastname: Lin
authors.forename: Ching-Hsi
authors.initials: CH
authors.lastname: Hsiao
mesh_terms: D000038:Abscess / Q000601:surgery; D000287:Administration, Topical; D000328:Adult; D000421:Alcaligenes; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002442:Ceftazidime / Q000008:administration & dosage / Q000627:therapeutic use; D016039:Corneal Transplantation / Q000009:adverse effects*; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007634:Keratitis / Q000382:microbiology* / Q000473:pathology; D008297:Male; D010878:Piperacillin / Q000008:administration & dosage / Q000627:therapeutic use; D012008:Recurrence; D012086:Reoperation
chemical_list: D000900:Anti-Bacterial Agents; D002442:Ceftazidime; D010878:Piperacillin