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Published on: February 6, 2021
Streptococcus intermedius-associated late-onset endophthalmitis after trabeculectomy with adjunctive mitomycin C
Kiyofumi Mochizuki1, Masako Kumada, Shinsuke Suemori
1Department of Ophthalmology, Gifu University Graduate School of Medicine, Gifu, Japan.
Journal of Glaucoma
|January 15, 2009
Summary
Delayed-onset endophthalmitis in a congenital rubella syndrome patient was successfully treated. Streptococcus intermedius, a rare cause of bleb-associated endophthalmitis, responded well to intravitreal antibiotics and vitrectomy.
Area of Science:
- Ophthalmology
- Infectious Diseases
Background:
- Congenital rubella syndrome (CRS) can lead to ocular complications.
- Bleb-related endophthalmitis is a serious post-surgical complication, often associated with trabeculectomy.
Observation:
- A 33-year-old woman with CRS presented with delayed-onset endophthalmitis in her right eye, 11 years after bilateral trabeculectomy with mitomycin C.
- She had a history of bleb leak treated with topical antimicrobials prior to symptom onset.
- Clinical presentation included redness and blurred vision, indicative of intraocular inflammation.
Findings:
- Anterior chamber tap and vitreous biopsy were performed.
- Cultures revealed Streptococcus intermedius, identified via DNA sequencing.
- The patient's vision improved to 30/200 with no residual inflammation after treatment.
Implications:
- This case highlights Streptococcus intermedius as a potential pathogen in delayed-onset bleb-associated endophthalmitis.
- Prompt diagnosis and treatment with intravitreal antibiotics and vitrectomy are crucial for favorable outcomes.
- Vigilance in identifying bacterial pathogens is essential in managing endophthalmitis, particularly in immunocompromised patients or those with prior ocular surgery.
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