Recurrent Enterococcus faecalis endophthalmitis after phacoemulsification.
We present the first reported case of late recurrence of postoperative Enterococcus faecalis endophthalmitis after cataract surgery in a 45-year-old diabetic man. Culture-positive E faecalis endophthalmitis was diagnosed 2 days after uneventful phacoemulsification. Early vitrectomy with intravitreal and subconjunctival vancomycin and amikacin and topical vancomycin resulted in apparently complete clinical resolution after 4 months and a best corrected visual acuity of 20/25. Recurrent endophthalmitis with hypopyon occurred 7 months postoperatively and resolved with intravitreal vancomycin and topical prednisolone acetate 1%. However, the patient had a similar relapse at 9 months that resulted in deterioration of visual acuity to no light perception despite a repeat vitrectomy, intraocular lens explantation, capsular bag removal, and intravitreal antibiotics. The late recurrences could have been the result of persistent sequestration of the organism in the capsular bag.
Teoh
Stephen C B
SC
The Eye Institute, Tan Tock Seng Hospital, Singapore, Republic of Singapore. stephen_teoh@ttsh.com.sg
Lee
Jong-Jian
JJ
Chee
Caroline K L
CK
Au Eong
Kah-Guan
KG
D000583:Amikacin / Q000627:therapeutic use; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D009877:Endophthalmitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D013293:Enterococcus faecalis / Q000302:isolation & purification*; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011183:Postoperative Complications; D012008:Recurrence; D014640:Vancomycin / Q000627:therapeutic use; D014821:Vitrectomy
D014640:Vancomycin; D000583:Amikacin