Oral moxifloxacin and topical amikacin for Mycobacterium abscessus keratitis after laser in situ keratomileusis

J Cataract Refract Surg. 2010 May;36(5):843-6. doi: 10.1016/j.jcrs.2009.10.054.

Abstract

We report a case of Mycobacterium abscessus keratitis after elective laser in situ keratomileusis in a 19-year-old woman. The infection started 3 weeks after uneventful surgery, and the patient received multiple antimicrobial treatments without response. A corneal scrape isolate showed an acid-fast bacterium that was subsequently confirmed by culture to be M abscessus. Prompt treatment of oral moxifloxacin 400 mg twice daily and hourly topical amikacin 2.5% was started. Recovery occurred within the first week of treatment, with complete resolution 3 weeks after presentation. The final uncorrected distance visual acuity was 6/9. We comment on other reports of post-LASIK keratitis caused by M abscessus, the in vitro sensitivity to antibiotic agents described in the literature, and the use of oral moxifloxacin as a potential good alternative treatment based on its good ocular bioavailability, which in our case allowed resolution without the need for surgical intervention.

Publication types

  • Case Reports

MeSH terms

  • Administration, Oral
  • Administration, Topical
  • Amikacin / administration & dosage
  • Anti-Bacterial Agents / administration & dosage*
  • Aza Compounds / administration & dosage
  • Corneal Ulcer / diagnosis
  • Corneal Ulcer / drug therapy*
  • Corneal Ulcer / microbiology
  • Eye Infections, Bacterial / diagnosis
  • Eye Infections, Bacterial / drug therapy*
  • Eye Infections, Bacterial / microbiology
  • Female
  • Fluoroquinolones
  • Humans
  • Keratomileusis, Laser In Situ*
  • Moxifloxacin
  • Mycobacterium Infections, Nontuberculous / diagnosis
  • Mycobacterium Infections, Nontuberculous / drug therapy*
  • Mycobacterium Infections, Nontuberculous / microbiology
  • Nontuberculous Mycobacteria / isolation & purification*
  • Postoperative Complications*
  • Quinolines / administration & dosage
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Aza Compounds
  • Fluoroquinolones
  • Quinolines
  • Amikacin
  • Moxifloxacin