title: Case of late-onset bleb associated endophthalmitis caused by Rothia mucilaginosa.
abstract: Rothia mucilaginosa is a gram-positive coagulase-negative coccus of the family Micrococcaceae. Although R. mucilaginosa forms part of the oropharyngeal microflora, it has only recently been isolated in ocular infections. We report a case of a 41-year-old man who developed late-onset bleb-related endophthalmitis (BRE). He had undergone glaucoma surgery 21 years earlier and had a thin-walled cystic bleb prior to the development of endophthalmitis in his right eye. He immediately received intravitreal injections of ceftazidime and vancomycin, topical levofloxacin and cefmenoxime, and intravenous cefozopran. Culture of the aqueous humor specimen identified R. mucilaginosa by 16S rRNA sequence analysis. To our knowledge, this is the first report of late-onset BRE caused by R. mucilaginosa. Our case indicates that R. mucilaginosa can be a cause of late-onset BRE, and that molecular analysis is an accurate method to identify R. mucilaginosa.
authors.affiliation: Department of Ophthalmology, Gifu University Graduate School of Medicine, Gifu, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Oie
authors.affiliation: Department of Ophthalmology, Gifu University Graduate School of Medicine, Gifu, Japan.
authors.forename: Kiyofumi
authors.initials: K
authors.lastname: Mochizuki
authors.affiliation: Department of Ophthalmology, Gifu University Graduate School of Medicine, Gifu, Japan; Department of Ophthalmology, Toho University Ohashi Medical Center, Tokyo, Japan. Electronic address: kyoko.ish@gmail.com.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Ishida
authors.affiliation: Laboratory for Clinical Investigation, Gifu University Hospital, Gifu, Japan.
authors.forename: Asami
authors.initials: A
authors.lastname: Nakayama
authors.affiliation: Department of Microbiology, Tokyo Medical University Graduate School of Medicine, Tokyo, Japan.
authors.forename: Kiyofumi
authors.initials: K
authors.lastname: Ohkusu
mesh_terms: D000193:Actinomycetales Infections / Q000175:diagnosis*; D000328:Adult; D001768:Blister / Q000209:etiology / Q000382:microbiology; D003229:Conjunctival Diseases / Q000175:diagnosis* / Q000382:microbiology; D009877:Endophthalmitis / Q000175:diagnosis* / Q000382:microbiology; D020459:Genes, rRNA; D005901:Glaucoma / Q000150:complications; D006801:Humans; D008297:Male; D008835:Micrococcaceae / Q000235:genetics* / Q000302:isolation & purification; D017423:Sequence Analysis, RNA / Q000379:methods; D014130:Trabeculectomy / Q000009:adverse effects*
keywords: Late-onset bleb-related endophthalmitis; Rothia mucilaginosa; Sequence analysis