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European Journal of Ophthalmology Nov 2022Moraxella nonliquefaciens () is a low pathogenicity microorganism, which rarely causes ocular infections, unless there is a predisposing factor. The main clinical...
INTRODUCTION
Moraxella nonliquefaciens () is a low pathogenicity microorganism, which rarely causes ocular infections, unless there is a predisposing factor. The main clinical manifestation of ocular infections is endophthalmitis and only five cases of corneal infection have been reported. This work shows an update in corneal infections, and the first reported case of keratitis due to superinfecting herpes simplex infection.
CASE REPORT
A 84-year old woman with worsening of her herpes simplex keratitis, diagnosed, and treated 2 days before. The slit lamp showed deep paracentral infiltrate and hypopyon. A corneal sample was collected for culture prior to initiation of empiric antibiotic therapy with vancomycin and ceftazidime fortified, oral acyclovir, and cyclopentolate. The strain was identified as and topical antibiotic therapy was adjusted to ciprofloxacin and ceftazidime. After 2 weeks, the epithelial defect and the infiltrate were resolved and prednisolone was added to the regimen. As the corneal oedema and neovascularization decreased, acyclovir, and prednisolone were slowly tapered. About 4 months later, the visual outcome was 20/50 and the ophthalmic examination showed a clear cornea with a paracentral leucoma.
CONCLUSION
Keratitis due to is rare and should be suspected in patients with local predisposing factors such as corneal damage or previous corneal infection. Prompt and appropriate combined treatment for the predisposing lesions and the keratitis may improve the prognosis and avoid a more aggressive approach.
Topics: Acyclovir; Aged, 80 and over; Anti-Bacterial Agents; Ceftazidime; Ciprofloxacin; Cyclopentolate; Female; Humans; Keratitis, Herpetic; Moraxella; Prednisolone; Vancomycin
PubMed: 34015953
DOI: 10.1177/11206721211019565 -
BMJ Case Reports May 2023Infectious scleritis is a rare disease entity with potentially devastating visual sequelae. Here we present the clinical history, work-up and aetiology of an unusual...
Infectious scleritis is a rare disease entity with potentially devastating visual sequelae. Here we present the clinical history, work-up and aetiology of an unusual case of infectious scleritis.
Topics: Humans; Scleritis; Disease Progression; Moraxella; Rare Diseases
PubMed: 37221000
DOI: 10.1136/bcr-2022-254113 -
Journal of Infection and Public Health 2019Septic arthritis is a common rheumatologic condition with myriad microbiological causative agents. Moraxella is one of the very rare causes of septic arthritis. We... (Review)
Review
BACKGROUND
Septic arthritis is a common rheumatologic condition with myriad microbiological causative agents. Moraxella is one of the very rare causes of septic arthritis. We hereby present the third case of Moraxella nonliquefaciens septic arthritis and the first case in a hematopoietic stem cell transplant patient (HSCT) along with a brief review of the literature.
METHODS
We used PubMed with google search engine to search the literature for reported cases of moraxella septic arthritis.
RESULTS
Information on 19 other cases of moraxella infectious arthritis was found. M. catarrhalis was the most common species isolated. Only 2 reports on M. nonliquefaciens were found; the first one in a multiple myeloma patient and the second one in a diabetic patient on hemodialysis. Predisposing conditions included inflammatory arthritis, prosthetic joints, diabetes, Human Immunodeficiency Virus (HIV) infection, Hepatitis C, hemodialysis, esophageal cancer, valve replacements, alcoholism and Intravenous (IV) drug use. The age group of the reported cases ranged from 3 months to 78 years.
CONCLUSION
Infectious arthritis with Moraxella spp. is a very rare entity which can occur in any age group and in the setting of various underlying medical conditions.
Topics: Administration, Oral; Adult; Anti-Bacterial Agents; Arthritis, Infectious; Diagnosis, Differential; Elbow Joint; Hematopoietic Stem Cell Transplantation; Humans; Lymphoma, T-Cell; Male; Moraxella; Moraxellaceae Infections; Moxifloxacin; Postoperative Complications
PubMed: 30711347
DOI: 10.1016/j.jiph.2019.01.059 -
Microorganisms Jun 2019is an ocular bacterial pathogen isolated in cases of keratitis, conjunctivitis, and endophthalmitis. Gram-negative brick-shaped diplobacilli from ocular specimens, and...
is an ocular bacterial pathogen isolated in cases of keratitis, conjunctivitis, and endophthalmitis. Gram-negative brick-shaped diplobacilli from ocular specimens, and slow growth in culture, are early indications of ocular infection; however, identifying to species can be complex and inconsistent. In this study, bacteria consistent with were identified to species using: (1) DNA sequencing coupled with vancomycin susceptibility, (2) MALDI-TOF mass spectrometry, and (3) the Biolog ID system. Study samples consisted of nine ATCC controls, 82 isolates from keratitis, 21 isolates from conjunctivitis, and 4 isolates from endophthalmitis. The ATCC controls were correctly identified. For keratitis, 66 (80.5%) were identified as , 7 (9.0%) as , 5 (6%) as , 2 (2.5%) as , 1 (1.0%) as , and 1 (1.0%) as . For conjunctivitis, 9 (43.0%) were identified as , 6 (29.0%) as , 3 (14.3%) as , 2 (9.5%) as (), and 1 (4.5%) as . From endophthalmitis, 3 of 4 of the isolates were . Overall, . and were identified in 70% (75 of 107) and 13% (14 of 107) of cases, respectively, totaling 83% (89 of 107). and are important bacterial pathogens of the eye as determined by DNA sequencing, MALDI-TOF MS, and Biolog. Although is a clinical pathogen, other species of appear to have a prominent role in eye infections.
PubMed: 31167433
DOI: 10.3390/microorganisms7060163 -
The American Journal of Dermatopathology Apr 2022In this brief report, we describe a 16-year-old patient with pre-B-cell acute lymphoblastic leukemia on chemotherapy who presented to the emergency department with a...
In this brief report, we describe a 16-year-old patient with pre-B-cell acute lymphoblastic leukemia on chemotherapy who presented to the emergency department with a fever and "bruise-like" area on his left forearm. Empiric antibiotic therapy was initiated, and initial tissue biopsy demonstrated findings consistent with ecthyma gangrenosum. On day 4 of admission, initial blood cultures grew Moraxella nonliquefaciens, and targeted antibiotic therapy was initiated and continued for a total of 21 days. The patient was discharged after 6 days of in-patient therapy and made a full recovery. M. nonliquefaciens has been reported to be associated with multiple types of infection, but no cases of M. nonliquefaciens-associated ecthyma gangrenosum were identified in the literature review for this report. Given this unique case and the empiric risks and broad differential associated with cutaneous manifestations in immunocompromised patients, obtaining a skin biopsy for histological examination is imperative for diagnostic workup.
Topics: Adolescent; Anti-Bacterial Agents; Diagnosis, Differential; Ecthyma; Forearm; Humans; Immunocompromised Host; Male; Moraxella; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma
PubMed: 34991103
DOI: 10.1097/DAD.0000000000002125 -
Archivos de La Sociedad Espanola de... Nov 2020Bleb-related endophthalmitis is rare and appears months or years after surgery. The causative agents are usually streptococci or gram-negative bacteria. There are few...
Bleb-related endophthalmitis is rare and appears months or years after surgery. The causative agents are usually streptococci or gram-negative bacteria. There are few cases in the literature of endophthalmitis caused by Moraxella nonliquefaciens, and most are delayed-onset associated with blebitis after glaucoma filtration surgery. The case is presented of a 90-year-old patient with endophthalmitis in the right eye due to Moraxella nonliquefaciens associated with blebitis 10 years after glaucoma surgery. After treatment, disappearance of blebitis is observed 2weeks later and resolution of vitritis 29 days later, with recovery of vision to previous values (20/200). Endophthalmitis due to Moraxella nonliquefaciens is rare, and is associated with late onset blebitis after glaucoma filtration surgery. Despite the virulence of the clinical symptoms, the visual prognosis is usually favourable.
PubMed: 32561182
DOI: 10.1016/j.oftal.2020.05.012 -
Archivos de La Sociedad Espanola de... Jul 2020Moraxella keratitis can lead to important complications. Moraxella nonliquefaciens(M. nonliquefaciens) has the worst prognosis. Only three cases of corneal infections...
Moraxella keratitis can lead to important complications. Moraxella nonliquefaciens(M. nonliquefaciens) has the worst prognosis. Only three cases of corneal infections due to M. nonliquefaciens have been published. The case is presented of a 79-year-old man with bullous keratopathy, recently affected with severe infectious keratitis. Dense, deep, and central stromal infiltrates and hyphaema were detected. After the identification of M. nonliquefaciens in the culture, and given the progression of the condition, the initial empirical treatment was modified to topical ciprofloxacin and ceftazidime in accordance with the antibiogram, combining oral ciprofloxacin and amoxicillin-clavulanate. After 27 days, there was total resolution of the lesion, with central residual leucoma. Keratitis caused by M. nonliquefaciens is rare and must be suspected in elderly patients with local predisposing factors, such as corneal damage or previous eye surgery. Early antibiogram-guided treatment and close monitoring are important to avoid complications and poor compliance.
Topics: Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Ceftazidime; Ciprofloxacin; Corneal Opacity; Corneal Ulcer; Drug Substitution; Eye Infections, Bacterial; Humans; Hyphema; Male; Moraxella; Moraxellaceae Infections; Vancomycin
PubMed: 32241585
DOI: 10.1016/j.oftal.2020.02.012 -
IDCases 2021A 2-year-old, previously healthy, male presented with an insidious history of intermittent left knee pain and edema who had been evaluated in the emergency department on...
A 2-year-old, previously healthy, male presented with an insidious history of intermittent left knee pain and edema who had been evaluated in the emergency department on multiple occasions with unremarkable imaging and normal laboratory results. On the day of presentation, he had mild edema of the left knee and inability to bear weight. Synovial fluid analysis showed an elevated white cell count with neutrophil predominance and mildly elevated inflammatory markers, consistent with septic arthritis. He underwent knee arthrotomy with irrigation and debridement and was initiated on broad spectrum antibiotics. Cultures were negative, polymerase chain reaction for MRSA and were negative. He was started on a fifth-generation cephalosporin with resolution of symptoms, marked clinical improvement and normalization of inflammatory markers. The identification of the etiologic agent was possible due to detection of bacterial 16S rRNA gene amplification by PCR for in the synovial fluid. He completed a course of 3 weeks of parenteral antibiotics at home with full recovery.
PubMed: 34026535
DOI: 10.1016/j.idcr.2021.e01145 -
Enfermedades Infecciosas Y... May 2019
Topics: Aged; Aged, 80 and over; Female; Humans; Keratitis; Male; Moraxella; Moraxellaceae Infections
PubMed: 30389264
DOI: 10.1016/j.eimc.2018.10.007 -
BMC Infectious Diseases Oct 2019Moraxella nonliquefaciens is a usually non-pathogenic biofilm-producing Gram-negative coccobacillus which may colonize the upper respiratory tract, rarely causing...
BACKGROUND
Moraxella nonliquefaciens is a usually non-pathogenic biofilm-producing Gram-negative coccobacillus which may colonize the upper respiratory tract, rarely causing invasive disease. Although very rare, bloodstream infections caused by this organism have been described, showing often a fatal outcome. Here, we report the case of a pediatric cancer patient with bloodstream infection and sepsis due to M. nonliquefaciens showing full recovery after appropriate antibiotic treatment.
CASE PRESENTATION
A three-year-old boy with stage IV neuroblastoma was admitted for high-dose chemotherapy with autologous stem cell rescue after standard neuroblastoma treatment. Despite receiving antimicrobial prophylaxis with trimethoprim/sulfamethoxazole, acyclovir and amphothericin B, the patient presented with fever of up to 39.5 °C and neutropenia. Besides a chemotherapy-related mucositis and an indwelling Broviac catheter (removed), no infection focus was identified on physical examination. Moraxella nonliquafaciens was identified in blood cultures. After antibiotic treatment and neutrophil recovery, the patient was fit for discharge.
CONCLUSIONS
The case described highlights the importance of an otherwise non-pathogenic microorganism, especially in immunosupressed cancer patients. It should be kept in mind that, although very infrequently, Moraxella nonliquefaciens may cause bloodstream infections that can be successfully treated with prompt focus identification and antibiotic therapy.
Topics: Anti-Bacterial Agents; Antineoplastic Agents; Bacteremia; Child, Preschool; Humans; Male; Moraxella; Neoplasm Staging; Neoplasms; Neutropenia; Sepsis
PubMed: 31601195
DOI: 10.1186/s12879-019-4489-y