Atypical Blepharitis Caused by Gram Positive Rod Bacteria

Abstract

Blepharitis is an inflammation of the eye lid margin. The presenting symptoms including chronic irritation, a burning sensation, mild redness, and occasionally itching of the lid margins.We reported a case of a 36-year-old woman who had sustained discomfort on the right eyelid for one week. When the patient was first seen, the examination revealed multiple meibomian cysts. After initial treatment for meibomian gland dysfunction with topical antibiotic and corticosteroid ointment, the patient developed marked pain and worsening of the lesions. Scraping of the lid margin showed pleomorphic gram positive rods with club-shaped swelled ends in clumps. Culture for aerobic and anaerobic bacteria could not be obtained because specimen was lost. She was subsequently diagnosed with gram positive rod bacterial blepharitis caused by Corynebacterium spp. and Bacillus spp. Topical fortified vancomycin eyedrop and oral erythromycin were started, and a dramatic regression of blepharitis was observed with complete resolution within one week.