Mycobacterium haemophilum: a rare cause of endophthalmitis.
Nontuberculous mycobacterial (NTM) infections are becoming an increasingly important complication in ophthalmology, particularly among immunocompromised patients. We report a case of NTM in a 66-year-old male immunosuppressed after cardiac transplantation. Chronic granulomatous iridocyclitis progressed to purulent endophthalmitis despite intraocular and systemic antimicrobial therapy. Direct immunoflourescent staining of the vitrectomy specimen revealed acid-fast bacilli. Biopsies of nodular skin lesions revealed non-caseating granulomas with acid-fast bacilli. Cultures of skin and eye biopsies yielded Mycobacterium haemophilum. Despite aggressive combination antimicrobial therapy, the eye was eventually enucleated. Resolution of systemic infection occurred with the addition of granulocyte macrophage-colony stimulating factor. This is the first reported case of M. haemophilum endophthalmitis.
Modi
Dimple
D
Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, UIC Eye Center, Chicago, Illinois 60612, USA.
Pyatetsky
Dmitry
D
Edward
Deepak P
DP
Ulanski
Lawrence J
LJ
Pursell
Kenneth J
KJ
Tessler
Howard H
HH
Goldstein
Debra A
DA
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D009877:Endophthalmitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D015353:Eye Enucleation; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D006084:Graft Rejection / Q000517:prevention & control; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000627:therapeutic use; D016027:Heart Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008297:Male; D009164:Mycobacterium Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D018393:Mycobacterium haemophilum / Q000302:isolation & purification*; D017192:Skin Diseases, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D014822:Vitreous Body / Q000382:microbiology
D000900:Anti-Bacterial Agents; D007166:Immunosuppressive Agents; D016178:Granulocyte-Macrophage Colony-Stimulating Factor