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Peer-reviewedCC BY 4.0Journal of Clinical Medicine

Unilateral Corneal Ulcer in a 2-Month-Old Infant Without Identifiable Predisposing Factors: A Case Report

  • Dunja Bajtl1,2
  • Vedran Nemet1,2
  • Ivanka Maduna2,3
  • Suzana Matić1,2
  • Maja Vinković1,2
  • Dubravka Biuk1,2
  • Marija Jelić Vuković1,2
  1. 1Department of Ophthalmology, Osijek University Hospital Centre, 31000 Osijek, Croatia
  2. 2Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
  3. 3Health Centre of Osijek-Baranja County, 31000 Osijek, Croatia
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Abstract

Background/Objectives: To describe the presentation, diagnostic evaluation, management, and clinical outcome of unilateral corneal ulcer in an otherwise healthy infant without identifiable predisposing factors. Methods: We report a case of a 2-month-old infant who presented with a visible white corneal lesion. Initial examination revealed a 2 × 1 mm fluorescein-positive corneal ulcer with a surrounding stromal infiltrate. There was mild conjunctival injection without ocular discharge. The anterior chamber was deep, without cells or flare. Corneal scraping was deferred because specimen collection would have required sedation or general anesthesia. Consequently, the microbial etiology remained unconfirmed, and empirical antimicrobial treatment was initiated. Results: The patient was treated with topical azithromycin, tobramycin, moxifloxacin, and aciclovir, as well as liposomal ozonized oil eye drops. During empirical treatment and close clinical monitoring, the corneal epithelial defect resolved within seven days, and the surrounding stromal infiltrate progressively decreased in size and opacity. At the one-month follow-up, a small residual stromal scar remained outside the visual axis. Conclusions: This case illustrates the diagnostic and therapeutic challenges of managing corneal ulcer in early infancy when microbiological confirmation is unavailable. The favorable clinical course observed during empirical treatment and close monitoring does not establish an infectious etiology or demonstrate a causal effect of antimicrobial therapy.

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Cite

BibTeXRIS
BibTeX
@article{bajtl2026unilateral,
  title = {{Unilateral Corneal Ulcer in a 2-Month-Old Infant Without Identifiable Predisposing Factors: A Case Report}},
  author = {Dunja Bajtl and Vedran Nemet and Ivanka Maduna and Suzana Matić and Maja Vinković and Dubravka Biuk and Marija Jelić Vuković},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = oct,
  doi = {10.3390/jcm15218420},
  url = {https://www.mdpi.com/2077-0383/15/21/8420},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Unilateral Corneal Ulcer in a 2-Month-Old Infant Without Identifiable Predisposing Factors: A Case Report
AU  - Dunja Bajtl
AU  - Vedran Nemet
AU  - Ivanka Maduna
AU  - Suzana Matić
AU  - Maja Vinković
AU  - Dubravka Biuk
AU  - Marija Jelić Vuković
PY  - 2026
DA  - 2026/10/29
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15218420
UR  - https://www.mdpi.com/2077-0383/15/21/8420
AB  - Background/Objectives: To describe the presentation, diagnostic evaluation, management, and clinical outcome of unilateral corneal ulcer in an otherwise healthy infant without identifiable predisposing factors. Methods: We report a case of a 2-month-old infant who presented with a visible white corneal lesion. Initial examination revealed a 2 × 1 mm fluorescein-positive corneal ulcer with a surrounding stromal infiltrate. There was mild conjunctival injection without ocular discharge. The anterior chamber was deep, without cells or flare. Corneal scraping was deferred because specimen collection would have required sedation or general anesthesia. Consequently, the microbial etiology remained unconfirmed, and empirical antimicrobial treatment was initiated. Results: The patient was treated with topical azithromycin, tobramycin, moxifloxacin, and aciclovir, as well as liposomal ozonized oil eye drops. During empirical treatment and close clinical monitoring, the corneal epithelial defect resolved within seven days, and the surrounding stromal infiltrate progressively decreased in size and opacity. At the one-month follow-up, a small residual stromal scar remained outside the visual axis. Conclusions: This case illustrates the diagnostic and therapeutic challenges of managing corneal ulcer in early infancy when microbiological confirmation is unavailable. The favorable clinical course observed during empirical treatment and close monitoring does not establish an infectious etiology or demonstrate a causal effect of antimicrobial therapy.
SN  - 2077-0383
ER  -