title: Bilateral simultaneous infectious keratitis secondary to contact lens wear: an unusual case report with rare organisms.
abstract: OBJECTIVE
  To report an unusual case of bilateral simultaneous hypopyon corneal ulcer in a contact lens wearer caused by polymicrobial infection with rare organisms.
  
  
  METHODS
  A case report of a 21-year-old soft contact lens wearer, who visited the emergency department with a 3-day history of pain, redness, decreased vision, photophobia, and tearing in both eyes. Examination showed a central corneal ulcer with hypopyon in both eyes. The cultures from corneal scrapings of both eyes, the contact lenses, and the contact lens solution showed heavy growth of Pseudomonas aeruginosa, Alkaligenes species, and Flavobacterium meningosepticum.
  
  
  RESULTS
  The corneal ulcers healed completely with aggressive antibiotic treatment for 4 weeks. The best-corrected visual acuity after 6 months of follow-up was 20/400 in the right eye and 20/60 in the left eye.
  
  
  CONCLUSIONS
  The possibility of infectious keratitis should be kept in mind for an acute red eye in contact lens wearers, and appropriate initial management is essential for a successful outcome. It is believed that this is the first report of Flavobacterium meningosepticum as a causative organism in contact lens-related keratitis.
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. nadiramali@hotmail.com
authors.forename: Nadir Ali Mohamed
authors.initials: NA
authors.lastname: Ali
authors.forename: Sagili Chandrasekhara
authors.initials: SC
authors.lastname: Reddy
mesh_terms: D000328:Adult; D000421:Alcaligenes; D000867:Anterior Chamber; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003263:Contact Lenses, Hydrophilic / Q000009:adverse effects*; D003320:Corneal Ulcer / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D004359:Drug Therapy, Combination; D005260:Female; D045826:Flavobacteriaceae Infections / Q000188:drug therapy; D005417:Flavobacterium; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy; D006801:Humans; D007634:Keratitis / Q000150:complications / Q000382:microbiology* / Q000503:physiopathology; D011552:Pseudomonas Infections / Q000188:drug therapy; D013492:Suppuration / Q000209:etiology; D014792:Visual Acuity; D014945:Wound Healing
chemical_list: D000900:Anti-Bacterial Agents