Endogenous endophthalmitis caused by methicillin-resistant Staphylococcus aureus (MRSA).
OBJECTIVE
To report clinical features, diagnostic features, and outcome in three patients presenting with fulminant endogenous endophthalmitis caused by methicillin-resistant Staphylococcus aureus.


METHODS
Retrospective review of clinical data and microbiological findings in three cases.


RESULTS
All three patients had predisposing conditions for endogenous endophthalmitis (B-cell lymphoma, diabetes mellitus, steroid therapy, or gastrointestinal symptoms, such as vomiting and diarrhea). Two patients were colonized by methicillin-resistant Staphylococcus aureus in typical sites (nose, groin, throat, and conjunctiva), whereas one patient who developed phlebitis at the infusion puncture site followed by bacteremia presented no typical colonization. Despite adequate therapy, two patients lost visual function in the infected eye, one of which had to be enucleated. The other patient's eye regained adequate function.


CONCLUSIONS
Endogenous endophthalmitis by methicillin-resistant Staphylococcus aureus is a rare but serious condition. Early and specific therapy based on reliable detection of the underlying microorganism may help in preventing loss of visual function.
Ness
Thomas
T
University Eye Hospital, Freiburg, Germany. thomas.ness@uniklinik-freiburg.de
Schneider
Christian
C
D000368:Aged; D000867:Anterior Chamber / Q000382:microbiology; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001766:Blindness / Q000209:etiology; D009877:Endophthalmitis / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D015353:Eye Enucleation; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D008875:Middle Aged; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D014640:Vancomycin / Q000627:therapeutic use; D014792:Visual Acuity; D014822:Vitreous Body / Q000382:microbiology
D000900:Anti-Bacterial Agents; D014640:Vancomycin