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Intravitreal Injection and Quantitation of Infection Parameters in a Mouse Model of Bacterial Endophthalmitis
Published on: February 6, 2021
Delayed-Onset Post-Keratoplasty Endophthalmitis Caused by Vancomycin-Resistant Enterococcus faecium
Julio C Hernandez-Camarena1, Victor M Bautista-de Lucio, Alejandro Navas
1Department of Cornea and Refractive Surgery, Instituto de Oftalmologia 'Conde de Valenciana', Mexico City, Mexico.
Case Reports in Ophthalmology
|November 28, 2012
Summary
This case report details a rare instance of delayed vancomycin-resistant Enterococcus (VRE) endophthalmitis following corneal transplant surgery. Prompt treatment with systemic linezolid and intravitreal antibiotics showed some improvement, but visual prognosis remains guarded.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Microbiology
Background:
- Vancomycin-resistant Enterococcus (VRE) endophthalmitis post-penetrating keratoplasty (PKP) is exceptionally rare and poses management challenges due to antibiotic resistance and disease severity.
- This study presents the first reported case of delayed-onset VRE endophthalmitis after PKP.
Observation:
- A 51-year-old female presented with endophthalmitis 7 weeks after PKP, exhibiting light perception visual acuity and significant vitreous inflammation.
- Mode B ultrasound confirmed posterior pole involvement, and pars plana vitrectomy was performed with intravitreal antibiotic administration.
Findings:
- Vitreous cultures identified vancomycin-resistant Enterococcus faecium; donor rim cultures and viral PCR were negative.
- Treatment involved repeated intravitreal antibiotics and systemic linezolid, leading to clinical improvement but persistent visual impairment.
Implications:
- VRE endophthalmitis may be linked to contaminated donor corneal rim cultures.
- Early administration of systemic linezolid alongside intravitreal antibiotics is recommended, though visual outcomes remain guarded.
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