May 2005
Volume 46, Issue 13
ARVO Annual Meeting Abstract  |   May 2005
Streptococcus Mitis Corneal Ulcer
Author Affiliations & Notes
  • V.J. Hsu
    School of Medicine, Loma Linda University, Loma Linda, CA
  • J. Affeldt
    Dept of Ophthalmology, Doheny Eye Institute, Keck School of Medicine of USC, Los Angeles, CA
  • C. Blanton
    School of Medicine, Loma Linda University, Loma Linda, CA
  • Footnotes
    Commercial Relationships  V.J. Hsu, None; J. Affeldt, None; C. Blanton, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science May 2005, Vol.46, 2632. doi:
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      V.J. Hsu, J. Affeldt, C. Blanton; Streptococcus Mitis Corneal Ulcer . Invest. Ophthalmol. Vis. Sci. 2005;46(13):2632.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract: : Purpose: Streptococcus mitis is a member of the Strep. viridans group, and has been previously implicated ocular infection–wise in only a single case of crystalline keratitis. The purpose of this report is to document for the first time a case of ulcerative keratitis associated with Strep. mitis. Methods: Observation case report Results: A 39 year–old soft–contact lens–wearing female presented with a eight day history of pain and decreased vision OS. Exam revealed light perception vision, and a severe corneal ulcer exhibiting total (100%) corneal opacification and a 2.5 mm x 2.5 mm descemetoceole. Culture identified Strep. mitis sensitive (MIC's) to the following antibiotics: Gatifloxan 0.12, Moxifloxacin 0.25, Ciprofloxain >2, Levofloxacin 2, Vancomycin 0.5, and Clindamycin <0.3. Despite aggressive q1 hour treatment with topical Gatifloxacin 0.3%, the cornea perforated requiring emergency penetrating keratoplasty. BCVA at last exam was 20/200. Conclusions: Streptococcus mitis is a rarely encountered but potentially devastating ocular pathogen. Fortunately, however, it appears to be highly sensitive to the commercially available fourth–generation fluoroquinolones (Gatifloxacin and Moxifloxacin), as well as Vancomycin.

Keywords: keratitis 

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