title: Dolosigranulum pigrum keratitis: a three-case series.
abstract: BACKGROUND
  Dolosigranulum pigrum is a commensal inhabitant of the upper respiratory tract suspected to be responsible for ocular infections but no well-described case of D. pigrum corneal infection has been reported. Herein culture and PCR-sequencing-based investigations of corneal scraping specimens confirmed D. pigrum keratitis in three patients.
  
  
  METHODS
  Three elderly patients presented with unilateral keratitis. None was a corneal-contact lens wearer, one had previous cataract surgery and another suffered rheumatoid arthritis sicca syndrome. Culturing the corneal scraping specimen was positive for two cases and PCR-sequencing of bacterial 16S rDNA in the presence of negative controls identified D. pigrum in three cases. The two D. pigrum isolates were in-vitro susceptible to penicillin G, amoxicillin, doxycycline, rifampicin and gentamicin. In all cases, surgical treatment of corneal thinning was necessary, but corneal perforation occurred in two cases despite intensive antimicrobial treatment with ticarcillin, gentamicin and vancomycin or levofloxacin eye drops leading to enucleation in one case.
  
  
  CONCLUSIONS
  D. pigrum is the likely cause of corneal infection in three patients, with effective antibiotic treatment in two patients.
authors.affiliation: Bacteriology department, Pôle des Maladies Infectieuses, Assistance Publique - Hôpitaux de Marseille and Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, UMR CNRS, Faculté de médecine, Marseille, France.
authors.forename: Magali
authors.initials: M
authors.lastname: Sampo
authors.forename: Oaufeh
authors.initials: O
authors.lastname: Ghazouani
authors.forename: Dominique
authors.initials: D
authors.lastname: Cadiou
authors.forename: Elodie
authors.initials: E
authors.lastname: Trichet
authors.forename: Louis
authors.initials: L
authors.lastname: Hoffart
authors.forename: Michel
authors.initials: M
authors.lastname: Drancourt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015818:Eye Infections, Bacterial / Q000382:microbiology*; D005260:Female; D006094:Gram-Positive Bacteria / Q000235:genetics / Q000302:isolation & purification; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology*; D006801:Humans; D007634:Keratitis / Q000382:microbiology*; D008297:Male; D016133:Polymerase Chain Reaction; D012329:RNA, Bacterial / Q000032:analysis; D012336:RNA, Ribosomal, 16S / Q000032:analysis
chemical_list: D012329:RNA, Bacterial; D012336:RNA, Ribosomal, 16S