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Mycobacterium haemophilum necrotising keratitis in a cornea with no prior surgical intervention

Year: 2025

Type: article

Abstract: A well-managed hypertensive and dyslipidaemic female in her 60s presented with a 4 month history of progressive visual decline, ocular irritation and localised erythema in her right eye. These ocular symptoms were associated with repeated exposure to environmental water sources. Clinical evaluation revealed marked conjunctival injection, corneal oedema, diffuse stromal haze and a dense infiltrate with a 6×6 mm epithelial defect at the central cornea. A penetrating keratoplasty revealed acid-fast bacilli in the corneal pathology, confirmed as Mycobacterium haemophilum via the line probe assay. Mycobacterial growth was absent in culture. A comprehensive treatment regimen, including systemic amikacin, levofloxacin, rifampicin, azithromycin and topical antituberculous therapy, resulted in significant clinical improvement. This case highlights M. haemophilum as an infrequent cause of non-tuberculous mycobacterial keratitis. Recurrent eye contact with contaminated water was shown as a notable risk factor in the absence of prior corneal interventions.

Source: BMJ Case Reports

DOI: 10.1136/bcr-2024-260340

Authors: Pichanon Mingchay, Lita Uthaithammarat, Usanee Reinprayoon, Voraphoj Nilaratanakul

Institutions: Chulalongkorn University, King Chulalongkorn Memorial Hospital

Language: English

Topic: Ocular Infections and Treatments

Subfield: Ophthalmology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Funder: Chulalongkorn University