[Group G streptococci as pathogens of postoperative endophthalmitis]

We report an exceptional case of fulminant endophthalmitis after uncomplicated extracapsular cataract extraction with posterior chamber lens implantation. The first unusual finding was the causative organisms, group G streptococci. These organisms are commonly found as normal flora of the skin, pharynx and gastrointestinal tract. They are also well known as pathogens of neonatal sepsis, otitis media and pneumonia, but there are only three case reports describing a streptococcus G endophthalmitis. The second unusual finding was the delayed onset of the fulminant endophthalmitis, occurring later than 9 days after surgery. A retrospective analysis of 17 additional cases showed that endophthalmitis occurred either during the first 5 days after surgery or later than 35 days after surgery. If endophthalmitis developed shortly after surgery it progressed rapidly and with intense inflammation. The other cases showed more chronic inflammatory reaction. From the latter finding we conclude that long postoperative monitoring remains necessary even if at first no signs of intraocular inflammation are detectable.