title: Rare Case of Polymicrobial Keratitis With Balantidium coli.
abstract: OBJECTIVE
  To report a rare case of polymicrobial keratitis due to Balantidium coli and gram-negative bacteria, Pseudomonas aeruginosa and Klebsiella pneumoniae, in a soft contact lens (CL) wearer.
  
  
  METHODS
  We report a case of CL-related keratitis due to B. coli, P. aeruginosa, and K. pneumoniae.
  
  
  RESULTS
  The culture of the corneal scrapings, the CL cleaning solution, and the CL revealed the growth of a rare ciliated parasite, B. coli, along with gram-negative bacteria, namely, P. aeruginosa and K. pneumoniae. The patient was successfully treated with topical broad-spectrum antibiotics and intravenous metronidazole.
  
  
  CONCLUSIONS
  Polymicrobial keratitis has seldom been reported with B. coli as the causative agent. CL wear can be a risk factor for this infection. Treatment with topical antibiotics may not suffice, and the intravenous route of antiprotozoal drugs may be a useful adjunct. Increasing awareness, early diagnosis, and treatment may improve the final visual outcome.
authors: Departments of *Ophthalmology; and†Microbiology, Kasturba Medical College, Manipal University, Manipal, Udupi, Karnataka, India.
authors: Manali
authors: M
authors: Hazarika
authors: Vijaya
authors: V
authors: Pai H
authors: Vinay
authors: V
authors: Khanna
authors: Harish
authors: H
authors: Reddy
authors: Kriti
authors: K
authors: Tilak
authors: Kiran
authors: K
authors: Chawla
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D001447:Balantidiasis / Q000188:drug therapy / Q000209:etiology*; D001448:Balantidium / Q000302:isolation & purification*; D060085:Coinfection; D003263:Contact Lenses, Hydrophilic / Q000382:microbiology / Q000469:parasitology; D003320:Corneal Ulcer / Q000188:drug therapy / Q000382:microbiology* / Q000469:parasitology*; D004359:Drug Therapy, Combination; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000209:etiology*; D015822:Eye Infections, Parasitic / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D007710:Klebsiella Infections / Q000188:drug therapy / Q000209:etiology; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000209:etiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000981:Antiprotozoal Agents; D008795:Metronidazole