Enterobacter Cloacae keratitis after corneal cross-linking for keratoconus: A case report.

PURPOSE: To report a case of Enterobacter cloacae (E. cloacae) keratitis in a patient who underwent corneal crosslinking (CXL) for progressive keratoconus.

OBSERVATIONS: A 19-year-old female underwent CXL for keratoconus in her left eye. The patient neglected her post-procedure medications and missed the follow-up visit. Subsequently, she presented on day-10 post CXL with redness and pain in the treated eye. Clinical examination revealed a ring-shape infiltrate measuring 7.8 mm in diameter. Culture indicated the presence of E. cloacae. Treatment with gentamicin failed after the emergence of resistance. The patient was successfully treated with amikacin and moxifloxacin over several weeks.

CONCLUSIONS

Judicious antibiotic selection is crucial to limit the emergence of resistance in multidrug-resistant (MDR) pathogens. All patients need to be educated about their role in the management plan.