Bacillus cereus endophthalmitis following intravitreous bevacizumab injection

The first case of Bacillus cereus endophthalmitis following an intravitreous injection of bevacizumab is described. A 77-year-old man presented to a retina specialist with an active choroidal neovascularization related to age-related macular degeneration for which he received intravitreous bevacizumab (1.25 mg) and post-injection topical gatifloxacin. Eight hours later, the patient woke up with excruciating pain and a decline in vision associated with nausea and vomiting. A vitreous biopsy was performed that revealed B. cereus. Despite intravitreous injections of vancomycin and ceftazidime on day 1 and pars plana vitrectomy with repeat intravitreous injections on day 3, the eye did not recover light perception.