Delayed onset and recurrent Alcaligenes xylosoxidans keratitis.

Alcaligenes xylosoxidans (formerly Achromobacter xylosoxidans) is an opportunistic aerobic gram-negative rod that is oxidase positive and nonlactose fermenting. It may be confused with other gram-negative bacteria such as Pseudomonas aeruginosa (1). The organism was first described and named in 1971 by Yabuuchi and Ohyama (2), who isolated the organism from purulent ear discharge of seven patients. It is frequently found in moist areas of hospitals and is resistant to many antimicrobial agents (3). Alcaligenes xylosoxidans is a transient colonizer of human gastrointestinal or respiratory tract in patients with cystic fibrosis (4). Its mode of transmission is often unknown, although it frequently involves exposure of debilitated patients to contaminated fluids or medical solutions (1,5,6). It has caused bacteremia, urinary tract infections, meningitis, wound infections, pneumonia, and peritonitis (6). To our knowledge, only five cases of A. xylosoxidans keratitis have been reported (Table 1). We report a case of posttraumatic A. xylosoxidans keratitis that recurred after apparent resolution.