Pneumococcal keratitis: a clinical profile

Abstract

AIM: To study the clinical features of pneumococcal keratitis and response to ciprofloxacin therapy. METHODS: A retrospective analysis was undertaken of 58 patients with culture-proven pneumococcal keratitis seen over a period of 2 years. RESULTS: Pneumococcal keratitis accounted for 33.3% of bacterial keratitis. Most cases presented with non-severe keratitis (77.5%). Co-existing sac pathology was more frequent in pneumococcal ulcers as compared to non-pneumococcal bacterial ulcers (50%vs 9%, P < 0.001). Characteristic clinical features enabling an accurate clinical diagnosis were found in 27.5% and lanceolate diplococci on Gram's stain were identified in 76% of cases. In vitro testing showed a high susceptibility to cephazolin and ciprofloxacin. All patients received ciprofloxacin as first-line therapy. Eighty per cent responded well with complete healing of the ulcer. A second drug was required in 8.5%. CONCLUSION: Ciprofloxacin therapy can be effective in the treatment of pneumococcal keratitis.