Post-traumatic endophthalmitis involving Clostridium tetani and Bacillus spp.
OBJECTIVE
To report a case of post-traumatic infectious endophthalmitis caused by Clostridium tetani and Bacillus spp.


METHODS
Case report.


RESULTS
A 25-year-old man developed endophthalmitis after a traumatic corneoscleral laceration of his right eye by a concrete reinforcement bar. He underwent pars plana lensectomy and vitrectomy with aspiration of vitreous fluid and a conjunctival swab for cultures. Cultures from the conjunctival swab were negative for organisms. Cultures of the vitreous aspirate were positive for Bacillus species and C. tetani. He had received a tetanus toxoid booster at the emergency department. By the time the culture results became available, he had developed severe eye pain associated with marked orbital congestion, increased swelling and erythema of the lids, marked injection and chemosis of the conjunctiva, and subsequently underwent evisceration. The inflammation resolved after evisceration of the right eye, and he was discharged to home on doxycycline 100 mg orally two times daily for 10 days.


CONCLUSIONS
We are unaware of previous reports of endophthalmitis involving C tetani and could find none in a computerized MEDLINE search. Patients with penetrating eye injury should be assessed for tetanus immunization status, and early intervention with tetanus toxoid booster and/or tetanus immune globulin should be considered if cultures are positive.
Iyer
M N
MN
Department of Internal Medicine, The Christ Hospital, Cincinnati, Ohio 45219, USA.
Kranias
G
G
Daun
M E
ME
D000328:Adult; D001407:Bacillus / Q000302:isolation & purification*; D002387:Cataract Extraction; D003017:Clostridium tetani / Q000302:isolation & purification*; D065306:Corneal Injuries; D009877:Endophthalmitis / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D017234:Eye Evisceration; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D015807:Eye Injuries, Penetrating / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D006801:Humans; D008297:Male; D012421:Rupture; D012590:Sclera / Q000293:injuries*; D013742:Tetanus / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D014821:Vitrectomy; D014822:Vitreous Body / Q000382:microbiology