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Coryneform endophthalmitis. Two case reports.

J W McManaway1, R S Weinberg, P E Coudron

  • 1Department of Ophthalmology, Medical College of Virginia, Richmond.

Archives of Ophthalmology (Chicago, Ill. : 1960)
|July 1, 1990
PubMed
Summary

Diphtheroids, once dismissed as contaminants, are now recognized causes of ocular infections. This study details two cases of post-cataract surgery endophthalmitis caused by diphtheroids, highlighting delayed treatment responses.

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Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Microbiology

Background:

  • Diphtheroids are increasingly implicated in ocular infections.
  • Cataract extraction and intraocular lens implantation are common procedures.
  • Corticosteroid use can predispose patients to ocular infections.

Observation:

  • Two patients developed endophthalmitis after cataract surgery and intraocular lens implantation.
  • Both patients had prior treatment for presumed sterile endophthalmitis with corticosteroids.
  • Vitreous cultures revealed pure growth of a diphtheroid, identified as coryneform group A-4.

Findings:

  • The diphtheroid isolates showed a delayed response to standard intraocular antibiotics (gentamicin and cefazolin).
  • Despite delayed response, both patients achieved restoration of functional vision.

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  • Antibiotic minimum inhibitory and bactericidal concentrations may explain the delayed therapeutic effect.

    • Implications:

    • Diphtheroids should be considered in the differential diagnosis of post-operative endophthalmitis.
    • Understanding diphtheroid antibiotic sensitivities is crucial for effective treatment.
    • Further research into diphtheroid pathogenicity and treatment is warranted.