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Delayed posttraumatic Propionibacterium acnes endophthalmitis in a child
1W K Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor 48105, USA.
Propionibacterium acnes can cause delayed endophthalmitis after penetrating eye trauma, persisting in the aphakic eye. Prompt treatment with vitrectomy and intravitreal vancomycin resolved inflammation in a pediatric case.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Microbiology
Background:
- Penetrating eye injuries can lead to serious intraocular infections.
- Delayed endophthalmitis is a challenging complication, often requiring aggressive management.
Observation:
- A 7-year-old boy developed granulomatous anterior uveitis two months post-trauma.
- Initial treatments including corticosteroids and vancomycin injections were ineffective.
Findings:
- Pars plana vitrectomy, capsulectomy, and intravitreal vancomycin led to complete resolution of inflammation.
- Cultures and pathology confirmed sequestered Propionibacterium acnes infection within capsular remnants.
Implications:
- Propionibacterium acnes should be considered in delayed endophthalmitis following penetrating trauma.
- Infection can remain sequestered in capsular remnants in aphakic eyes, necessitating targeted surgical and antimicrobial approaches.
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