Bacillus circulans endophthalmitis.
An 80-year-old woman presented with right endophthalmitis, characterized by chalky white deposits covering her posterior capsule. This occurred 17 months after uncomplicated right cataract surgery. A three-port pars plana vitrectomy and partial posterior capsulectomy isolated Bacillus circulans, and the patient made a rapid and full recovery on topical cephalothin and prednisolone acetate 1%. The case demonstrates that, unlike endophthalmitis due to other Bacillus spp., B. circulans endophthalmitis does not necessarily follow a fulminant course. It is the first report describing a subacute presentation, and response to posterior capsulectomy and simple antibiotic therapy It is also the first description of B. circulans causing white plaques in the posterior capsule, a finding characteristic of chronic endophthalmitis and previously considered pathognomonic of Proprionibacterium acnes endophthalmitis.
Tandon
A
A
Ophthalmology Department, Royal Perth Hospital, WA, Australia. justin@icenet.com.au
Tay-Kearney
M L
ML
Metcalf
C
C
McAllister
L
L
D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use; D016863:Bacillaceae Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D001407:Bacillus / Q000302:isolation & purification*; D002511:Cephalosporins / Q000627:therapeutic use; D002512:Cephalothin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D009877:Endophthalmitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007903:Lens Capsule, Crystalline / Q000382:microbiology / Q000473:pathology / Q000601:surgery; D008826:Microbial Sensitivity Tests; D015242:Ofloxacin / Q000627:therapeutic use; D011239:Prednisolone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014821:Vitrectomy
D000890:Anti-Infective Agents; D002511:Cephalosporins; D005938:Glucocorticoids; C009935:prednisolone acetate; D011239:Prednisolone; D015242:Ofloxacin; D002512:Cephalothin