Failure of Listeria monocytogenes keratitis to respond to topical ofloxacin

Purpose: The purpose of this case report is to demonstrate the need for identification of the offending pathogen in bacterial keratitis to guide appropriate treatment.Methods: Case report.Results: We report a case of Listeria monocytogenes keratitis in a young healthy adult that failed to respond to standard empirical therapy for bacterial keratitis but was treated successfully with topical ampicillin, chloramphenicol, and systemic amoxicillin.Conclusion: This case demonstrates the need for identification of the offending pathogen to guide appropriate treatment. It also demonstrates discrepancy between in vitro sensitivity and clinical response.