Endogenous endophthalmitis due to Listeria monocytogenes

The authors report a case of Listeria monocytogenes endophthalmitis in a patient who had undergone cardiac revascularization surgery and was receiving systemic corticosteroids. The organism was isolated both in the aqueous humor and in blood culture. The infection was successfully treated with intravenous crystalline penicillin, but the patient developed a bullous keratopathy and secondary glaucoma, resulting in poor visual acuity (counting fingers at 0.5 m). The visual acuity recovered to 20/30 after a penetrating keratoplasty and the glaucoma was controlled with a Molteno implant and a trabeculectomy combined with administration of mitomycin. Listeria monocytogenes endogenous endophthalmitis should be suspected in any immunosuppressed patient with severe anterior uveitis, especially when a brown hypopyon, high intraocular pressure and corneal edema are present.