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[A case of metastatic Enterococcus faecalis endophthalmitis]
Nippon Ganka Gakkai Zasshi
|June 1, 1991
Summary
This case study details the successful treatment of metastatic endophthalmitis caused by Enterococcus faecalis using vitrectomy and lensectomy. Early intervention led to significant vision recovery in a diabetic patient.
Area of Science:
- Ophthalmology
- Infectious Diseases
Background:
- Metastatic endophthalmitis is a severe intraocular infection that can lead to vision loss.
- Enterococcus faecalis is a less common cause of endophthalmitis, particularly in the metastatic form.
Observation:
- A 50-year-old male with poorly controlled diabetes developed bilateral iridocyclitis and fever post-necrotic cholecystitis surgery.
- The patient presented with light perception loss in the right eye and hand motion visual acuity with severe uveitis, cataract, and vitreous opacity in the left eye.
- Gram-positive cocci, identified as Enterococcus faecalis, were isolated from the vitreous aspirate.
Findings:
- Successful treatment was achieved with lensectomy and vitrectomy, including antibiotic irrigation.
- Systemic antibiotics and human immunoglobulin administration post-surgery resulted in remarkable ocular fundus improvement.
- Visual acuity in the left eye recovered to 4/20 within 60 days post-operation.
Implications:
- This case highlights the importance of prompt diagnosis and aggressive surgical and medical management for metastatic endophthalmitis.
- Early intervention with vitrectomy and lensectomy can lead to significant visual recovery even in advanced cases.
- The report contributes to the limited literature on Enterococcus faecalis metastatic endophthalmitis, especially in Japan.