PMC10234703_01
Keratitis caused by an unnamed human oral Bergeyella sp. (a) 2.5 months after onset with scleral injection and inferior nasal thickening of the cornea. Corneal epithelium was intact. (b) Incomplete blanching after phenylephrine 2.5% drops. (c, d) Six weeks following subconjunctival triamcinolone injection (2 mg in each quadrant). Corneal epithelium remained intact. (e) High magnification of the midstromal lesion. (f) Partial improvement 3 months after initiation of antibiotic therapy.
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Two weeks later, 2.5 months after symptom onset, our initial examination revealed 3+ scleral injection with incomplete blanching after phenylephrine administration, uniform edema of the inferotemporal corneal stroma with several large inferior keratic precipitates, and 1+ cells in the anterior chamber with no visible hypopyon (Figures 1(a) and 1(b)). Six weeks later, the patient returned with left eye visual acuity of hand motion, 4+ scleral injection, 0.75-millimeter hypopyon (Figure 1(c)), and new circular stromal corneal opacities (Figures 1(c) and 1(d)). These opacities were midstromal with a flat appearance and mild adjacent corneal edema but otherwise clear overlying stroma and intact epithelium (Figure 1(e)). At his final in-person visit, his vision in the left eye was 20/30, the scleral injection was graded as trace, and the paracentral corneal stromal infiltrate was partially reabsorbed, with a moth-eaten appearance (Figure 1(f)).
The phylogenetic tree includes 27 sequences representing the most closely related records in the Nucleotide database of the National Center for Bioinformatics, including all established Bergeyella spp. The patient sequence (highlighted, bold) forms a high-confidence clade (93% bootstrap) with unnamed human oral Bergeyella spp. and is quite distant from B. zoohelcum, B. porcorum, and B. cardium. Tree generated from the alignment of trimmed 16S ribosomal ribonucleic acid gene records and generated in IQ-Tree with generalized midpoint optimization and bootstrap branch support of 1000 ultrafast replicates; scale is substitutions per site.
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