Streptococcus mitis/oralis Corneal Ulcer in a Patient with Severe Rheumatoid Arthritis: An Unusual Route

Purpose. To report a case of Streptococcus mitis oralis (S. mitis/oralis) corneal ulcer in a patient with a possible preventable cause. Methods. Cultures were obtained from a 64-year-old woman with a 3.5 mm×5 mm corneal ulcer with hypopyon in the left eye. Results. Culture reports demonstrated the g...

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Main Authors: Mustafa Jaffry, Mark Lister
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Case Reports in Ophthalmological Medicine
Online Access:http://dx.doi.org/10.1155/2022/5245620
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author Mustafa Jaffry
Mark Lister
author_facet Mustafa Jaffry
Mark Lister
author_sort Mustafa Jaffry
collection DOAJ
description Purpose. To report a case of Streptococcus mitis oralis (S. mitis/oralis) corneal ulcer in a patient with a possible preventable cause. Methods. Cultures were obtained from a 64-year-old woman with a 3.5 mm×5 mm corneal ulcer with hypopyon in the left eye. Results. Culture reports demonstrated the growth of S. mitis/oralis, a commensal organism of the oral flora. Fortified vancomycin 5% eye drops were started, and the patient was counseled on the rarity of the bacteria as an etiology of corneal ulcers. On the return visit, the patient, who works in a doctor’s office, volunteered information that the preservative free artificial tear vials that she used were difficult to open because of her hand deformity due to rheumatoid arthritis; thus, she had to bite the vials open. Conclusions. S. mitis/oralis is an organism commonly found in the mouth but is rarely found in the eye. We report a unique case of an immunocompromised patient with rheumatoid arthritis, severe dry eye, and a history of multiple episodes of keratolysis, who developed a corneal ulcer from a rare pathogen, with a plausible and preventable route of infection.
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spelling doaj-art-a601fcf2544940358190f2cab0d1d35e2025-08-20T03:38:48ZengWileyCase Reports in Ophthalmological Medicine2090-67302022-01-01202210.1155/2022/5245620Streptococcus mitis/oralis Corneal Ulcer in a Patient with Severe Rheumatoid Arthritis: An Unusual RouteMustafa Jaffry0Mark Lister1Rutgers New Jersey Medical SchoolNew York Medical CollegePurpose. To report a case of Streptococcus mitis oralis (S. mitis/oralis) corneal ulcer in a patient with a possible preventable cause. Methods. Cultures were obtained from a 64-year-old woman with a 3.5 mm×5 mm corneal ulcer with hypopyon in the left eye. Results. Culture reports demonstrated the growth of S. mitis/oralis, a commensal organism of the oral flora. Fortified vancomycin 5% eye drops were started, and the patient was counseled on the rarity of the bacteria as an etiology of corneal ulcers. On the return visit, the patient, who works in a doctor’s office, volunteered information that the preservative free artificial tear vials that she used were difficult to open because of her hand deformity due to rheumatoid arthritis; thus, she had to bite the vials open. Conclusions. S. mitis/oralis is an organism commonly found in the mouth but is rarely found in the eye. We report a unique case of an immunocompromised patient with rheumatoid arthritis, severe dry eye, and a history of multiple episodes of keratolysis, who developed a corneal ulcer from a rare pathogen, with a plausible and preventable route of infection.http://dx.doi.org/10.1155/2022/5245620
spellingShingle Mustafa Jaffry
Mark Lister
Streptococcus mitis/oralis Corneal Ulcer in a Patient with Severe Rheumatoid Arthritis: An Unusual Route
Case Reports in Ophthalmological Medicine
title Streptococcus mitis/oralis Corneal Ulcer in a Patient with Severe Rheumatoid Arthritis: An Unusual Route
title_full Streptococcus mitis/oralis Corneal Ulcer in a Patient with Severe Rheumatoid Arthritis: An Unusual Route
title_fullStr Streptococcus mitis/oralis Corneal Ulcer in a Patient with Severe Rheumatoid Arthritis: An Unusual Route
title_full_unstemmed Streptococcus mitis/oralis Corneal Ulcer in a Patient with Severe Rheumatoid Arthritis: An Unusual Route
title_short Streptococcus mitis/oralis Corneal Ulcer in a Patient with Severe Rheumatoid Arthritis: An Unusual Route
title_sort streptococcus mitis oralis corneal ulcer in a patient with severe rheumatoid arthritis an unusual route
url http://dx.doi.org/10.1155/2022/5245620
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AT marklister streptococcusmitisoraliscornealulcerinapatientwithsevererheumatoidarthritisanunusualroute