PURPOSE: To report the first documented case of keratitis secondary to the gram-negative bacillus Brevundimonas diminuta. METHODS: A 66-year-old woman with an ocular history of bilateral soft contact lens wear presented with a large, 6×9-mm, culture-positive Pseudomonas aeruginosa-induced corneal ulcer. After weeks of therapy, she developed secondary keratitis. Repeat cultures grew a rare, gram-negative bacillus, B. diminuta. RESULTS: Targeted therapy followed by adjustments based on repeat bacterial cultures with sensitivities resulted in slow resolution of the ulcer. After months of therapy, the cornea recovered leaving only a minimal corneal scar. Visual acuity improved from a low of Hand Motions to a final 20/40. CONCLUSIONS: This is the first reported case of ocular infection with B. diminuta. This case demonstrates the need to be aware of potential rare secondary infections in corneas compromised by an initial infection and to adjust pharmacotherapy based on sensitivities and clinical signs.
