Acute bilateral postoperative endophthalmitis in a HLA-DQ5-positive patient: possible susceptibility to infections.
An unusual case of bilateral acute endophthalmitis in association with the HLA-DQ5 histocompatibility antigen is reported. A 35-year-old woman with high myopia and cataracts in both eyes underwent phacoemulsification procedures performed in separate sessions using different viscoelastic substances and following the same strict prophylactic measures. After each surgical procedure, she developed S. epidermidis acute endophthalmitis in the right eye and Propionibacterium acnes acute endophthalmitis in the left eye; both were successfully treated with capsular bag irrigation and intracameral vancomycin (1 mg/0.1 mL). She tested positive for the HLA-DQ5 (DQ1), DQ2 antigen. The question is raised as to whether the HLA-DQ5 histocompatibility antigen may be a predisposing factor for both staphylococcal and P. Acnes acute endophthalmitis. A multicenter prospective study is proposed to identify this HLA antigen in all patients scheduled for cataract surgery who have a history of postoperative endophthalmitis in the fellow eye.
Nicoli
C L
CL
Department of Ophthalmology, Oftalmos, Instituto Oftalmologico de Alta Complejidad, University of Buenos Aires, Republica Argentina. nicoli@mbox.servicenet.com.ar
Wainsztein
R D
RD
D000208:Acute Disease; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001082:Aqueous Humor / Q000382:microbiology; D002387:Cataract Extraction; D009877:Endophthalmitis / Q000188:drug therapy / Q000235:genetics / Q000382:microbiology*; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000235:genetics / Q000382:microbiology; D005260:Female; D020022:Genetic Predisposition to Disease; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000235:genetics / Q000382:microbiology; D006683:HLA-DQ Antigens / Q000032:analysis*; D006801:Humans; D019654:Lens Implantation, Intraocular; D011183:Postoperative Complications / Q000188:drug therapy / Q000382:microbiology*; D011425:Propionibacterium acnes / Q000302:isolation & purification*; D013212:Staphylococcus epidermidis / Q000302:isolation & purification*; D014640:Vancomycin / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D006683:HLA-DQ Antigens; C410042:HLA-DQ5 antigen; D014640:Vancomycin