Ocular Microbiology and Immunology Group
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2026 OMIG Abstract

POSTER PRESENTATION


Refractory Scleral Abscess with Isolation of Corynebacterium Jeikeium Managed with Rose Bengal Photodynamic Antimicrobial Therapy

Zishuai Chou, Pragat Jay Muthu, Darlene Miller, Jaime David Martinez Martinez, and Carol L Karp

Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida

Purpose: To report a rare refractory corneal ulcer and scleral abscess associated with Corynebacterium jeikeium (C. jeikeium) managed with multimodal therapy including rose bengal photodynamic antimicrobial therapy (RB-PDAT).

Methods: A 92-year-old woman with Descemet stripping endothelial keratoplasty (DSEK) 6 years prior to presentation and chronic prednisolone acetate use in both eye (OU). She also had a Xen gel implant (done in 2014). She presented with a conjunctival abscess and corneal ulceration the right eye (OD). Despite negative cultures, she was treated empirically with hourly fortified topical vancomycin & moxifloxacin. There was initial improvement but subsequently developed a limbal abscess with progressive scleral thinning, prompting repeat cultures and surgical intervention.

Results: Repeat cultures yielded C. jeikeium (susceptible to vancomycin) on multiple plates and Klebsiella pneumoniae (pan-sensitive) only in thioglycolate broth. The patient received subconjunctival injection of vancomycin and gentamicin (V&G), followed by abscess drainage with conjunctival biopsy, intraoperative RB-PDAT, amniotic membrane placement, and subconjunctival V&G. Intraoperative cultures and pathology showed no growth. Postoperatively, the inflammation and infiltrates improved, the epithelial defect resolved, and no recurrent abscess or infection was observed.

Conclusions: C. jeikeium is a rare organism, which may lead to corneal ulcers or scleral abscesses. Prolonged topical antibiotic and corticosteroid exposure, ocular implants, and prior corneal surgery may promote colonization and biofilm formation by C. jeikeium. Its biofilm production, cell wall characteristics, and antimicrobial resistance may complicate eradication. RB-PDAT may be a useful adjunct in managing refractory ocular surface and scleral infections.