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Case Reports
. 2024 Jul 4:36:102097.
doi: 10.1016/j.ajoc.2024.102097. eCollection 2024 Dec.

Bacillus coagulans- associated severe necrotizing scleral infection

Beau Sylvester  1 , Spencer D Fuller  2 , Laura Certain  3 , Akbar Shakoor  1 , Thuy Doan  4
Affiliations
Case Reports

Bacillus coagulans- associated severe necrotizing scleral infection

Beau Sylvester et al. Am J Ophthalmol Case Rep. .

Abstract

Purpose: We describe a case of severe scleritis possibly caused by Bacillus coagulans.

Observations: Conventional laboratory evaluation was inconclusive. The associated organism was identified with metagenomic RNA deep sequencing (MDS). The infection resolved with trimethoprim-sulfamethoxazole treatment.

Conclusions: This case demonstrates the utility of unbiased, high-throughput sequencing for infectious scleritis.

Keywords: Fastidious organism; Next generation sequencing; Sclerokeratitis; Uveitis; bacillus.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Clinical images of the left eye and clinical course of the patient. Abbreviations: ANA = anti-nuclear antibody; MPO/PR3 ANCA = myeloperoxidase and proteinase 3 antineutrophil cytoplasmic antibody; RF = rheumatoid factor; CCP = cyclic citrullinated peptide; SS-A & SS-B Ab = anti-Sjogren's syndrome A and anti-Sjogren's syndrome B antibody; ACE = angiotensin converting enzyme; C3 and C4 = complement components 3 and 4; C50 = total complement activity; HBsAb = hepatitis B serum antibody; Hep C Ab CIA = hepatitis C antibody by chemiluminescence immunoassay; HSV I & II IgG = herpes simplex virus I and II immunoglobulin G; EBV nuclear Ag = Epstein Barr virus nuclear antigen; CMV IgM = cytomegalovirus immunoglobulin M; RPR/FTA-Abs = rapid plasma reagin and fluorescent treponemal antibody absorption; VZV IgG = varicella zoster virus immunoglobulin G; PMN = polymorphonuclear neutrophil; PCR = polymerase chain reaction; MDS = metagenomic deep sequencing.
Fig. 2
Fig. 2
Characterization of posterior extension of disease by fundus photography, ultrasonography, and optical coherence tomography (OCT) of the macula. Imaging acquired in June of 2020 demonstrates subretinal necrosis superotemporally on fundus photograph (A), hypoechoic fluid accumulation in sub-Tenon's space on ultrasound b-scan (B), and intraretinal fluid and macular edema on OCT of the macula (C).
See this image and copyright information in PMC

References

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