title: STENOTROPHOMONAS MALTOPHILIA ENDOPHTHALMITIS 1 MONTH AFTER INTRAVITREAL AFLIBERCEPT.
abstract: OBJECTIVE
  Endophthalmitis caused by Stenotrophomonas maltophilia is rare and has been described after cataract surgery and open globe injuries. We report a patient with endophthalmitis caused by this organism after uncomplicated intravitreal aflibercept injection.
  
  
  METHODS
  A 70-year-old man with a history of anti-vascular endothelial growth factor therapy for diabetic macular edema presented 23 days after aflibercept injection with clinical diagnosis of endophthalmitis. The patient initially had mild pain, conjunctival congestion, and anterior chamber cell; 2 days later, the patient returned with hand motion visual acuity, hypopyon, and dense vitritis.
  
  
  RESULTS
  A tap and inject procedure was performed. The aqueous sample confirmed the presence of S. maltophilia. Antimicrobial testing showed susceptibility to ceftazidime which was used during the initial treatment. After resolution of the vitritis and hypopyon, the visual acuity returned to 20/70 at his 3-month follow-up examination.
  
  
  CONCLUSIONS
  Stenotrophomonas maltophilia is a rare infectious agent associated with intravitreal injection and may present 1 month after treatment.
authors.affiliation: Department of Ophthalmology, University of Wisconsin, Madison, Wisconsin.
authors.forename: Paul S
authors.initials: PS
authors.lastname: Boeke
authors.forename: Justin L
authors.initials: JL
authors.lastname: Gottlieb
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002442:Ceftazidime / Q000627:therapeutic use; D003930:Diabetic Retinopathy / Q000188:drug therapy; D009877:Endophthalmitis / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D006801:Humans; D058449:Intravitreal Injections / Q000009:adverse effects; D008269:Macular Edema / Q000188:drug therapy; D008297:Male; D040262:Receptors, Vascular Endothelial Growth Factor / Q000008:administration & dosage / Q000037:antagonists & inhibitors; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage / Q000009:adverse effects*; D020615:Stenotrophomonas maltophilia / Q000302:isolation & purification*; D014792:Visual Acuity
chemical_list: D000900:Anti-Bacterial Agents; D011993:Recombinant Fusion Proteins; C533178:aflibercept; D002442:Ceftazidime; D040262:Receptors, Vascular Endothelial Growth Factor