Oxacillin-resistant Staphylococcus aureus endophthalmitis after ganciclovir intraocular implant.
OBJECTIVE
To describe a patient who developed oxacillin-resistant Staphylococcus aureus endophthalmitis after insertion of a ganciclovir intraocular implant.


METHODS
Case report.


RESULTS
A 42-year-old man with acquired immunodeficiency syndrome (AIDS) and a history of cytomegalovirus retinitis was admitted with right-sided eye pain and decreased visual acuity 10 days after receiving a second ganciclovir intraocular implant in the right eye. A therapeutic vitrectomy, right eye, was performed on the day of admission. A vitreal tap produced frank pus and white, fluffy debris. Cultures of the vitreal fluid grew oxacillin-resistant S aureus, sensitive only to vancomycin, rifampin, and trimethoprim/sulfamethoxazole. The patient was successfully treated with removal of both ganciclovir implants in the right eye and a 4-week course of vancomycin and rifampin. However, the infection left the patient blind in the infected eye.


CONCLUSIONS
Bacterial endophthalmitis is an infrequent but serious complication of the ganciclovir intraocular implant.
Williamson
J C
JC
Department of Pharmacy, University of North Carolina Hospitals and Clinics, Chapel Hill, North Carolina, USA. johnwill@wfubmc.edu
Virata
S R
SR
Raasch
R H
RH
Kylstra
J A
JA
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy; D000328:Adult; D017726:Cytomegalovirus Retinitis / Q000188:drug therapy; D004343:Drug Implants / Q000009:adverse effects*; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D009877:Endophthalmitis / Q000382:microbiology* / Q000628:therapy; D015818:Eye Infections, Bacterial / Q000209:etiology / Q000628:therapy; D015774:Ganciclovir / Q000008:administration & dosage; D006801:Humans; D008297:Male; D010068:Oxacillin / Q000627:therapeutic use*; D010403:Penicillin Resistance; D010406:Penicillins / Q000494:pharmacology; D012086:Reoperation; D013203:Staphylococcal Infections / Q000209:etiology / Q000628:therapy; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification; D014822:Vitreous Body / Q000382:microbiology
D004343:Drug Implants; D010406:Penicillins; D015774:Ganciclovir; D010068:Oxacillin