Acute endophthalmitis caused by Staphylococcus lugdunesis after intravitreal bevacizumab (Avastin) injection.
OBJECTIVE
To report a case of culture-positive endophthalmitis after intravitreal injection of bevacizumab (Avastin) resulting in a devastating visual outcome.


METHODS
A retrospective case report of a 51-year-old diabetic women who presented with further decrease in her vision, redness, and mild pain in her eye 3 days after intravitreal injection of Avastin for macular edema due to a branch retinal vein occlusion.


RESULTS
Clinical diagnosis of endophthalmitis was made and, after obtaining a vitreous tap, intravitreal antibiotics were administered. Because of worsening of the endophthalmitis, pars plana vitrectomy was undertaken followed by repeat intravitreal antibiotics injection. The patient's ocular condition improved dramatically; however, her visual acuity did not improve. The cultures from vitreous taps revealed Staphylococcus lugdunesis.


CONCLUSIONS
Intravitreal injection of Avastin may be associated with a risk of S. lugdunesis-caused endophthalmitis which can have a devastating effect on the final visual outcome.
King Khalid Eye Specialist Hospital, Riyadh, Saudi Arabia. hisham121@hotmail.com
Hisham S
HS
Alkuraya
Abdullah S
AS
Al-Kharashi
Essam
E
Alharthi
Imtiaz A
IA
Chaudhry
D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D004359:Drug Therapy, Combination; D009877:Endophthalmitis / Q000382:microbiology* / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D005260:Female; D006801:Humans; D056965:Injections, Intraocular / Q000009:adverse effects*; D007908:Lens, Crystalline / Q000601:surgery; D008269:Macular Edema / Q000188:drug therapy / Q000209:etiology; D008875:Middle Aged; D012170:Retinal Vein Occlusion / Q000150:complications; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000209:etiology*; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods; D014822:Vitreous Body
D000900:Anti-Bacterial Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab