Propionibacterium acnes endophthalmitis: an unusual manner of presentation

An unusual clinical presentation of Propionibacterium acnes endophthalmitis as a solitary nodule on the corneal endothelial surface at the superior limbus in association with granulomatous uveitis is reported. The patient had previous extracapsular cataract surgery with intraocular lens implantation and two subsequent YAG laser capsulotomies. The organism was grown from a microbiopsy of the nodule after a negative anterior chamber tap. The patient was treated with systemic antibiotics, his condition worsened, and the implant, lens capsule, and anterior vitreous were surgically removed. No additional organisms were found and there was no evidence of coexistent phacoanaphylaxis. The patient had no further inflammation and attained 20/25 aphakic vision.