Corneal infection by Pseudomonas stutzeri following excision of trigeminal nerve schwannoma.

ABSTRACT

A 25-year-old woman underwent intracranial surgery for trigeminal nerve schwannoma (TGNS) with persistent left-sided facial hypoaesthesia. Two months later, she developed a central corneal ulceration. Scraping of the corneal lesion revealed Gram-negative bacilli. Genus level identification was achieved using standard techniques and species level identification, revealing Pseudomonas stutzeri, was aided by a VITEK 2 compact system. Broad-spectrum fortified antibiotics were initially started followed by species-sensitive fortified antibiotics. Ocular surface toxicity developed a week later; this was managed with a non-fortified antibiotic. The epithelial defect healed in 3 weeks with subsequent corneal scar formation. Visual rehabilitation was achieved with deep anterior lamellar keratoplasty. Six months following surgery, the patient had a visual acuity of 20/40 with -1.25 170° -0.5 refractive correction and a clear graft. This case report, for the first time, highlights P. stutzeri, an aetiological agent of corneal ulcer following excision of TGNS and its successful management.