title: Streptococcus intermedius-associated late-onset endophthalmitis after trabeculectomy with adjunctive mitomycin C.
abstract: OBJECTIVE
  To report a woman with congenital rubella syndrome of delayed-onset, bleb-related endophthalmitis induced by Streptococcus intermedius.
  
  
  METHODS
  Interventional case report.
  
  
  RESULTS
  A 33-year-old woman who underwent bilateral trabeculectomy with adjunctive mitomycin C, 11 years earlier presented with redness and blurred vision in her right eye. She had received a topical antimicrobial agent because of bleb leak before presentation. She underwent anterior chamber tap and complete vitrectomy with intravitreal antibiotics. Cultures from the vitreous aspirate grew gram-positive cocci. The DNA from the microorganism was sequenced and identified as S. intermedius. Three months after the surgical intervention, her right eye showed no residual inflammation with a best-corrected visual acuity of 30/200.
  
  
  CONCLUSIONS
  Bleb-associated endophthalmitis caused by S. intermedius is responsive to intravitreal antibiotics and vitrectomy, and special care should be taken to identify a bacterial pathogen.
authors.affiliation: Department of Ophthalmology, Gifu University Graduate School of Medicine, Gifu, Japan.
authors.forename: Kiyofumi
authors.initials: K
authors.lastname: Mochizuki
authors.forename: Masako
authors.initials: M
authors.lastname: Kumada
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Suemori
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kawakami
authors.forename: Akira
authors.initials: A
authors.lastname: Sawada
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Hiroshige
authors.initials: H
authors.lastname: Mikamo
mesh_terms: D000328:Adult; D000477:Alkylating Agents / Q000008:administration & dosage*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004269:DNA, Bacterial / Q000032:analysis; D004359:Drug Therapy, Combination; D009877:Endophthalmitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D006801:Humans; D016685:Mitomycin / Q000008:administration & dosage*; D013290:Streptococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D034367:Streptococcus intermedius / Q000235:genetics / Q000302:isolation & purification*; D014130:Trabeculectomy / Q000009:adverse effects*; D014821:Vitrectomy; D014822:Vitreous Body / Q000382:microbiology
chemical_list: D000477:Alkylating Agents; D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D016685:Mitomycin