title: Stenotrophomonas maltophilia endogenous endophthalmitis: clinical presentation, antibiotic susceptibility, and outcomes.
abstract: OBJECTIVE
  To describe clinical presentation, antibiotic susceptibility, and outcomes in patients with Stenotrophomonas maltophilia endogenous endophthalmitis.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Four eyes of four patients with S. maltophilia endogenous endophthalmitis.
  
  
  METHODS
  Retrospective chart review of culture-positive S. maltophilia endogenous endophthalmitis treated at L V Prasad Eye Institute, Hyderabad, India, between January 2007 and December 2012, was done. Collected information included demographic, clinical, and microbiology data.
  
  
  RESULTS
  These four patients with S. maltophilia endogenous endophthalmitis cases accounted for 0.47% (4/836) of total bacterial endophthalmitis cases treated in this period. All patients were from a rural setting and younger than 40 years. Two of the four patients had a history of immune compromise or hospitalization. The visual acuity at presentation was less than 20/320 in all patients. Common presenting features were severe anterior and posterior segment inflammation and hypopyon. All patients underwent vitrectomy with injection of intravitreal antibiotics and dexamethasone. Direct microscopy of the vitreous sample was positive in all cases. All isolates were sensitive to fluoroquinolones and chloramphenicol; sensitivity to aminoglycosides and third-generation cephalosporins was highly variable. The final visual acuity was 20/80 or more in three patients. The time to presentation did not seem to influence the visual or anatomical outcome.
  
  
  CONCLUSIONS
  S. maltophilia is a rare cause of endogenous endophthalmitis and usually occurs in young and apparently healthy individuals. Clinical presentation is moderate to severe, and recovery is variable. Fourth-generation fluoroquinolones and chloramphenicol were the most sensitive antibiotics against S. maltophilia in this series of patients.
authors.affiliation: Srimati Kannuri Santhamma Centre for Vitreoretinal Diseases, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, India.
authors.forename: Jay
authors.initials: J
authors.lastname: Chhablani
authors.affiliation: Srimati Kannuri Santhamma Centre for Vitreoretinal Diseases, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, India.
authors.forename: Aditya
authors.initials: A
authors.lastname: Sudhalkar
authors.affiliation: L V Prasad Eye Institute, GMR Varalakshmi Campus, Visakhapatnam, India.
authors.forename: Animesh
authors.initials: A
authors.lastname: Jindal
authors.affiliation: Srimati Kannuri Santhamma Centre for Vitreoretinal Diseases, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, India.
authors.forename: Taraprasad
authors.initials: T
authors.lastname: Das
authors.affiliation: Jhaveri Microbiology Centre, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, India.
authors.forename: Swapna R
authors.initials: SR
authors.lastname: Motukupally
authors.affiliation: Jhaveri Microbiology Centre, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, India.
authors.forename: Savitri
authors.initials: S
authors.lastname: Sharma
authors.affiliation: L V Prasad Eye Institute, GMR Varalakshmi Campus, Visakhapatnam, India.
authors.forename: Avinash
authors.initials: A
authors.lastname: Pathengay
authors.affiliation: Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami, Miller School of Medicine, Miami, FL, USA.
authors.forename: Harry W
authors.initials: HW
authors.lastname: Flynn
keywords: Pseudomonas maltophilia; Stenotrophomonas maltophilia; Xanthomonas maltophilia; endogenous endophthalmitis