A case of bilateral keratitis caused by Providencia
alcalifaciens: a rarely encountered ocular pathogen
Yong Sok Ji
Kyung Chul Yoon
Received: 23 August 2016 / Accepted: 8 May 2017 / Published online: 17 May 2017
Ó Springer Science+Business Media Dordrecht 2017
Purpose To report a case of keratitis caused by
Methods A 70-year-old man presented with pain,
redness, and decreased vision in both of his eyes. On
initial presentation, the visual acuity in both of his eyes
was hand motion, and slit lamp examination showed
diffuse inﬁltrates and total epithelial defects of the
cornea, conjunctival hyperemia, and severe anterior
chamber reactions with 2-mm-height hypopyon. The
results of laboratory studies revealed elevated liver
function tests, which indicated the presence of alco-
holic liver disease.
Results The culture result was positive for P.
alcalifaciens and showed sensitivity to ceftazidime
and amikacin but resistant to cefazolin, gentamicin,
ﬂuoroquinolone, and ampicillin. He was treated with
topical application and intravenous injection of cef-
tazidime. His keratitis resolved gradually over
3 months as the treatment dose was tapered and the
treatment was eventually discontinued. His ﬁnal visual
acuity was 20/200 in the right eye and 20/60 in the left
eye because of the remaining central corneal opacity.
Conclusions We report a ﬁrst case of keratitis due to
P. alcalifaciens in a chronic heavy alcohol drinker.
Ophthalmologists should consider this bacterium as a
potential pathogen of corneal ulceration, when clini-
cally suspect gram-negative bacterial keratitis espe-
cially in immunocompromised state.
Keywords Keratitis Á Providencia alcalifaciens Á
Providencia alcalifaciens is an emerging gram-nega-
tive rod-shaped bacterium that belongs to the Enter-
obacteriaceae family. Until now, several cases of P.
alcalifaciens-induced diarrhea and urinary tract infec-
tions in children and immunocompromised hosts from
developing countries have been documented [1–3].
However, corneal infection by this organism as a
single isolate has not been reported. Here, we describe
a ﬁrst case of bilateral corneal ulceration due to P.
alcalifaciens in a heavy alcohol drinker.
A 70-year-old man with a history of heavy alcohol
consumption presented to the outpatient clinic with
complaining of pain, redness, and decreased vision in
both of his eyes since 5 days prior. The patient
reported no previous history of trauma and systemic
W. Choi Á Y. S. Ji Á K. C. Yoon (&)
Department of Ophthalmology, Chonnam National
University Medical School and Hospital, 8 Hakdong,
Donggu, Gwangju 501-757, South Korea
Int Ophthalmol (2018) 38:1325–1328