title: Polymicrobial chronic endophthalmitis diagnosed by culture and molecular technique.
abstract: Accurate etiological diagnosis is the key to prevention of ocular morbidity in endophthalmitis cases. A 66 year old male was suffering from chronic endophthalmitis post-cataract surgery. Polymerase chain reaction examination on anterior chamber fluid was positive for Propionibacterium acnes but negative for the panfungal genome. He was advised vitrectomy with intravitreal injections. Polymerase chain reaction of vitreous aspirate was positive for P.acnes as well as panfungal genome. The vitreous sample also grew yeast in culture which was identified as Candida pseudotropicalis. Patient was treated on an alternate day regimen of intravitreal Vancomycin and Amphotericin B in the post-operative period. There was improvement in vision at final follow up. Chronic endophthalmitis can have polymicrobial etiology which will require appropriate diagnostic and therapeutic strategies. The role of molecular testing is vital in these cases as growth in culture is often negative.
authors.affiliation: Consultant Microbiologist, Sankara Nethralaya, Kolkata, West Bengal, India.
authors.forename: A
authors.initials: A
authors.lastname: Mukherjee
authors.forename: S
authors.initials: S
authors.lastname: Pramanik
authors.forename: D
authors.initials: D
authors.lastname: Das
authors.forename: R
authors.initials: R
authors.lastname: Roy
authors.forename: K L
authors.initials: KL
authors.lastname: Therese
mesh_terms: D000368:Aged; D000666:Amphotericin B / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use; D002175:Candida / Q000302:isolation & purification*; D002177:Candidiasis / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology / Q000628:therapy; D002908:Chronic Disease; D060085:Coinfection / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology / Q000628:therapy; D009877:Endophthalmitis / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology / Q000628:therapy; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology / Q000628:therapy; D006801:Humans; D008297:Male; D011425:Propionibacterium acnes / Q000302:isolation & purification*; D014640:Vancomycin / Q000627:therapeutic use; D014821:Vitrectomy
chemical_list: D000890:Anti-Infective Agents; D014640:Vancomycin; D000666:Amphotericin B