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Purpose: We present a case study regarding a patient with recurrent keratoconjunctivitis that presented as an initial manifestation of common variable immune deficiency (CVID).Methods: We describe a case and review the recent relevant medical literature.Results A 33-year-old male had recurrent keratoconjunctivitis induced by multi-drug resistant bacteria.Topical vancomycin treatment was effective, but infection recurred when the vancomycin treatment was stopped.The patient was transferred to the Department of Medicine to rule out potential systemic immune diseases, and was finally diagnosed with CVID.Intravenous immunoglobulin (IVIG) was administered and the patient was followed up monthly without recurrence of infection to date.IVIG will be administered monthly for the patients lifetime.