Burkholderia cenocepacia Keratitis With Exogenous Endopthalmitis: A Complex Combination

In this report, we present a case of <i>Burkholderia cenocepacia</i> (<i>B. cenocepacia</i>)keratitis with exogenous endophthalmitis in a post-vitrectomy eye. The patient was a 68-year-old man with a history of treated corneal laceration and endophthalmitis who presented with acute pain, redness, and lid swelling affecting the left eye following working at a palm oil plantation. There was a paracentral corneal stromal infiltrate with dense vitritis in his left eye. Cornea cultures grew <i>B. cenocepacia.</i> He received two modalities of antimicrobials, including intravitreal injections and intensive topical antibiotics. Pars plana vitrectomy was not performed due to poor corneal visibility from a previous trauma scar. His stromal infiltrates and vitreous opacity responded to therapy that was sensitive to this organism, and the keratitis healed with scarring after a month. The progression of <i>B. cenocepacia</i> keratitis to endophthalmitis can be rapid. Early identification and appropriate commencement of antibiotics can prevent detrimental sequelae, including blindness and loss of the eyeball.