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2026, Vol: 10, Issue: 6
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Case Report
Online Published: 01 May 2026
 


Aggressive sphingomonas paucimobilis keratitis in a diabetic patient with bullous keratopathy: a case report

Hussein Alneami, Abdulaziz Alagsam, Sarah J. Mobarki, Faisal Abusageah, Hanan Ali Alshafie.


Abstract
Background:
This study reported a case of fulminant Sphingomonas paucimobilis keratitis in a patient with significant ocular and systemic comorbidities.
Case Presentation:
A 73-year-old male with poorly controlled Type 2 diabetes and chronic bullous keratopathy presented with a central corneal ulcer. The clinical course was aggressive, and a hypopyon developed within four days despite broad-spectrum empirical treatment with cefazolin and ceftazidime. Microbiological investigation identified Sphingomonas paucimobilis. Susceptibility testing revealed resistance to both third-generation cephalosporins and fluoroquinolones. The isolate was sensitive to amikacin. Therapy was adjusted to fortified amikacin and vancomycin. The infection resolved rapidly following the change in antibiotics. The patient subsequently developed a massive corneal scar, and B-scan showed signs of choroidal detachment. A therapeutic penetrating keratoplasty (TPK) with IOL explantation was performed to preserve globe integrity. However, the final visual outcome was limited to light perception due to graft failure.
Conclusion:
Sphingomonas paucimobilis can exhibit aggressive behavior in compromised corneas. Pre-existing bullous keratopathy and uncontrolled diabetes are significant risk factors for severe disease. This case emphasized the increasing prevalence of antibiotic resistance in this organism. Early microbiological cultures and susceptibility-guided therapy are essential to prevent perforation and preserve globe integrity.

Key words: Sphingomonas paucimobilis, microbial keratitis, bullous keratopathy, diabetes mellitus, corneal ulcer, case report


 
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How to Cite this Article
Pubmed Style

Alneami H, Alagsam A, Mobarki SJ, Abusageah F, Alshafie HA. Aggressive sphingomonas paucimobilis keratitis in a diabetic patient with bullous keratopathy: a case report. IJMDC. Online First: 01 May, 2026. doi:10.24911/IJMDC.51-1770963769

Web Style

Alneami H, Alagsam A, Mobarki SJ, Abusageah F, Alshafie HA. Aggressive sphingomonas paucimobilis keratitis in a diabetic patient with bullous keratopathy: a case report. https://www.ijmdc.com/?mno=310354 [Access: June 22, 2026]. doi:10.24911/IJMDC.51-1770963769

AMA (American Medical Association) Style

Alneami H, Alagsam A, Mobarki SJ, Abusageah F, Alshafie HA. Aggressive sphingomonas paucimobilis keratitis in a diabetic patient with bullous keratopathy: a case report. IJMDC. Online First: 01 May, 2026. doi:10.24911/IJMDC.51-1770963769


Vancouver/ICMJE Style

Alneami H, Alagsam A, Mobarki SJ, Abusageah F, Alshafie HA. Aggressive sphingomonas paucimobilis keratitis in a diabetic patient with bullous keratopathy: a case report. IJMDC, [cited June 22, 2026]; Online First: 01 May, 2026. doi:10.24911/IJMDC.51-1770963769


Harvard Style

Alneami, H., Alagsam, . A., Mobarki, . S. J., Abusageah, . F. & Alshafie, . H. A. (2026) Aggressive sphingomonas paucimobilis keratitis in a diabetic patient with bullous keratopathy: a case report. IJMDC, Online First: 01 May, 2026. doi:10.24911/IJMDC.51-1770963769


Turabian Style

Alneami, Hussein, Abdulaziz Alagsam, Sarah J. Mobarki, Faisal Abusageah, and Hanan Ali Alshafie. 2026. Aggressive sphingomonas paucimobilis keratitis in a diabetic patient with bullous keratopathy: a case report. International Journal of Medicine in Developing Countries, Online First: 01 May, 2026. doi:10.24911/IJMDC.51-1770963769


Chicago Style

Alneami, Hussein, Abdulaziz Alagsam, Sarah J. Mobarki, Faisal Abusageah, and Hanan Ali Alshafie. "Aggressive sphingomonas paucimobilis keratitis in a diabetic patient with bullous keratopathy: a case report." International Journal of Medicine in Developing Countries Online First: 01 May, 2026. doi:10.24911/IJMDC.51-1770963769


MLA (The Modern Language Association) Style

Alneami, Hussein, Abdulaziz Alagsam, Sarah J. Mobarki, Faisal Abusageah, and Hanan Ali Alshafie. "Aggressive sphingomonas paucimobilis keratitis in a diabetic patient with bullous keratopathy: a case report." International Journal of Medicine in Developing Countries Online First: 01 May, 2026. Web. 22 Jun 2026 doi:10.24911/IJMDC.51-1770963769


APA (American Psychological Association) Style

Alneami, H., Alagsam, . A., Mobarki, . S. J., Abusageah, . F. & Alshafie, . H. A. (2026) Aggressive sphingomonas paucimobilis keratitis in a diabetic patient with bullous keratopathy: a case report. International Journal of Medicine in Developing Countries, Online First: 01 May, 2026. doi:10.24911/IJMDC.51-1770963769




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