Ocular hypersensitivitiy to topical vancomycin in a case of chronic endophthalmitis.
OBJECTIVE
To report a case of ocular allergy to topical vancomycin eye drops.


METHODS
Interventional case report.


RESULTS
A 76-year-old man presented with progressive itching, soreness, and burning sensations, photophobia, and tearing in his left eye 3 days after completing 2 weeks of treatment with 5% vancomycin eye drops. He had been suffering for the previous 2 years from chronic recurrent endophthalmitis and secondary glaucoma associated with cataract surgery in his left eye. He denied any history of drug or food allergy. Examination by slit-lamp microscope showed left periorbital skin erosive rash, marked hyperemia of conjunctiva, central epithelial defect, corneal stromal edema, and Descemet membrane striae. Vancomycin skin tests were positive. The patient's symptoms resolved after discontinuing vancomycin eye drops and responded well to systemic corticosteroids, antihistamines, and topical corticosteroid treatments. Teicoplanin treated his endophthalmitis successfully.


CONCLUSIONS
A case of hypersensitivity to topical vancamycin was reported. Patients who receive topical vancomycin should be informed of this possible adverse effect and instructed to contact their ophthalmologists if allergic reactions occur.
Hwu
Jinn-Jong
JJ
Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Chen
Ko-Hua
KH
Hsu
Wen-Ming
WM
Lai
Jui-Yang
JY
Li
Yen-Shien
YS
D000287:Administration, Topical; D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D002908:Chronic Disease; D004342:Drug Hypersensitivity / Q000175:diagnosis / Q000209:etiology*; D009877:Endophthalmitis / Q000188:drug therapy* / Q000382:microbiology; D005128:Eye Diseases / Q000139:chemically induced* / Q000175:diagnosis; D015818:Eye Infections, Bacterial / Q000188:drug therapy* / Q000382:microbiology; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D008297:Male; D009883:Ophthalmic Solutions / Q000009:adverse effects; D011425:Propionibacterium acnes / Q000302:isolation & purification*; D014640:Vancomycin / Q000009:adverse effects*
D000900:Anti-Bacterial Agents; D009883:Ophthalmic Solutions; D014640:Vancomycin