Enterococcus faecalis endophthalmitis as a metastatic complication of hemodialysis vascular access-related sepsis: A case report and review of the literature.
Catheter and/or arteriovenous (A-V) graft-related bacteremia is an important cause of morbidity and mortality among hemodialysis (HD) patients. Endocarditis, septic arthritis, epidural abscess, septic embolism, and osteomyelitis are the most common complications of catheter and/or A-V graft-related bacteremia; however, endogenous endophthalmitis is rarely seen. To the best of our knowledge, Enterococcus faecalis is the first case report in this population. We hereby report a case of endogenous endophthalmitis caused by E. faecalis as a complication of catheter and/or A-V graft-related bacteremia in a diabetic patient, who was undergoing HD for 5 years. We also discuss the etiology, clinical features, and outcomes of endogenous endophthalmitis in HD patients with a brief review of the literature. Although broad-spectrum parenteral (intravenous and intravitreal) antibiotics were used for 4 weeks, evisceration of the left eye could not be avoided. Endogenous endophthalmitis is a rare but rapidly blinding complication of catheter and/or A-V graft-related bacteremia in HD patients. It can develop as a result of silent catheter and/or A-V graft infections, which may lead to recurrent bacteremia. E. faecalis should be considered as a pathogen in this population who had recent history of catheter or A-V graft procedure.
Department of Internal Medicine, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey.
Osman Zikrullah
OZ
Sahin
Department of Internal Medicine, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey.
Ekrem
E
Kara
Department of Internal Medicine, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey.
Tahir
T
Belice
Department of Internal Medicine, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey.
Teslime
T
Ayaz
Department of Internal Medicine, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey.
Serap
S
Baydur Sahin
Department of Infectious Diseases, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey.
Cinar
C
Ozturk
Department of Internal Medicine, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey.
Safak
S
Yildirim
Department of Radiology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey.
Yavuz
Y
Metin
Department of Nephrology, Sisli Etfal Educational and Research Hospital, Istanbul, Turkey.
Tuncay
T
Sahutoglu
D009877:Endophthalmitis / Q000209:etiology*; D013293:Enterococcus faecalis; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000209:etiology*; D006801:Humans; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects*; D018805:Sepsis / Q000150:complications*; D062666:Vascular Access Devices / Q000009:adverse effects*
Enterococcus faecalis; arteriovenous graft; endophthalmitis; hemodialysis catheter