Stenotrophomonas maltophilia keratitis in penetrating keratoplasty

Stenotrophomonas maltophilia (S. maltophilia) is an emerging opportunistic ocular pathogen that should be included in the diff erential diagnosis of progressive keratitis in penetrating keratoplasty. Prognosis is poor because of the existence of co-infections and high antibiotic resistance. Th e present study reports two cases of keratitis caused by S. maltophilia in patients with penetrating keratoplasty, their clinical features and management. Case 1 showed co-infection with Propionibacterium sp. and Herpes simplex; in Case 2, antimicrobial susceptibility testing showed that S. maltophilia was resistant to ciprofl oxacin. Aggressive treatment in both cases, the use of newer quinolones and intrastromal treatment resolved infections. J Emmetropia 2016; 2: 95-98 Stenotrophomonas maltophilia (S. maltophilia) —previously called Pseudomonas maltophilia and Xanthomonas maltophilia— is an aerobic, non-fermenter, gram-negative bacillus that is readily isolated from water, soil, and various plants and animals1,2. Microbial keratitis due to S. maltophilia is rare. Ocular surface damage such as trauma, a history of penetrating keratoplasty, use of soft contact lenses and an immunocompromised surface play important roles in its pathogenesis3. Prognosis is poor because of high antibiotic resistance. We report two cases of S. maltophilia keratitis following penetrating keratoplasty that required aggressive treatment. As far as we are aware, no other cases of S. maltophilia keratitis treated with intrastromal antibiotic have been reported. CASE PRESENTATION