Document Type : Case reports


1 Department of Ophthalmology, The First Hospital of Jilin University, Changchun, China

2 Department of Cardiology, The First Affiliated Hospital of Jiamusi University, Heilongjiang, China

3 Department of Radiology, The First Hospital of Jilin University, Changchun, China


Introduction: Keratitis induced by type I hypersensitivity to metronidazole is rarely reported. In vivo confocal microscopy (IVCM)
is a promisingmethod for the investigation of cornealmorphology under pathological conditions. The purpose of the present study
was to investigate the IVCM features of keratitis associated with anaphylaxis to metronidazole and review the literature regarding
IVCM application to study drug-related changes in the cornea.
Case Presentation: A 50-year-old woman with acute bilateral keratitis induced by anaphylaxis to intravenous metronidazole presented to the Department of Ophthalmology, the first affiliated hospital of Jilin University, Changchun, China in Jan 2018. She initially experienced photophobia, moderate conjunctival injection, and watery discharge after infusion of intravenous metronidazole. These symptoms gradually resolved one month after she was administered anti-allergic drugs. Corneal morphology related to
anaphylaxis to metronidazole was investigated by IVCM before and after treatment. To our knowledge, this is the first reported case
of IVCM images of keratitis associated with anaphylaxis to metronidazole.
Conclusions: In vivo confocal microscopy can allow objective evaluation of treatment response through cellular changes in the
cornea and could provide good-quantity images of ocular surface tissues for follow-up