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A case of endogenous Enterococcus faecalis endophthalmitis.
1Department of Ophthalmology, Yokohama City University School of Medicine, Japan.
Japanese Journal of Ophthalmology
|January 1, 1992
Summary
A rare case of Enterococcus faecalis endophthalmitis in a diabetic patient was successfully treated with vitrectomy and lensectomy, restoring vision. This highlights effective surgical and antibiotic management for severe eye infections.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Microbiology
Background:
- Endogenous endophthalmitis is a severe intraocular infection.
- Enterococcus faecalis is a rare but serious cause of endophthalmitis, particularly in immunocompromised patients.
- Poorly controlled diabetes is a significant risk factor for endogenous infections.
Observation:
- A 50-year-old male with uncontrolled diabetes developed bilateral iridocyclitis and fever post-necrotic cholecystitis surgery.
- The patient presented with vision loss in the right eye and severe uveitis, cataract, and vitreous opacity in the left eye.
- Gram-positive cocci, identified as Enterococcus faecalis, were isolated from vitreous samples.
Findings:
- Prompt surgical intervention including lensectomy and vitrectomy with antibiotic irrigation was performed.
- Systemic antibiotics and human immunoglobulin were administered postoperatively.
- Significant improvement in ocular fundus and visual acuity (0.2 in the left eye) was observed within 60 days.
Implications:
- Vitrectomy and lensectomy are effective treatments for early-stage endogenous Enterococcus faecalis endophthalmitis.
- Early diagnosis and aggressive management are crucial for visual recovery in severe endophthalmitis.
- This case underscores the importance of considering rare pathogens in endophthalmitis, especially in diabetic patients.