1.Recalcitrant gram-positive bacterial keratitis treated with intrastromal levofloxacin 1.5% ophthalmic solution: A case report and review of literature
Bobbie Marie M. Santos ; Josept Mari S. Poblete ; George Michael N. Sosuan ; Pablito F. Sandoval Jr. ; Billie Jean T. Cordero ; David Ammiel R. Tirol V ; Ruben Lim Bon Siong
Philippine Journal of Ophthalmology 2024;49(1):54-60
Objective:
This paper demonstrated the effectiveness of intrastromal injection of levofloxacin 1.5%
ophthalmic solution in the management of recalcitrant Gram-positive bacterial keratitis.
Methods:
This is a report on two cases of recalcitrant bacterial keratitis encountered at the External Diseases
and Cornea Clinic of the Department of Ophthalmology and Visual Sciences at the Philippine General Hospital.
Results:
Two middle-aged females presented with bacterial keratitis unresponsive to previous antibiotic
treatment with impending corneal perforation. The Gram stain of the corneal scraping in the first case revealed Gram-positive cocci, while the second case showed encapsulated Gram-positive bacilli and encapsulated Grampositive cocci in chains. In both cases, repeated intrastromal injections of levofloxacin 1.5% in addition to increasing the frequency of topical levofloxacin 1.5% resulted in marked improvement in visual acuity and resolution of deep stromal infiltrates and hypopyon.
Conclusion
These cases highlighted the utility of intrastromal levofloxacin 1.5% ophthalmic solution in the
management of recalcitrant Gram-positive bacterial keratitis.
Fluoroquinolones
;
Levofloxacin