Postoperative herpetic endophthalmitis-A case report

We report a case of herpetic endophthalmitis following cataract surgery. A 65-year-old man underwent uneventful phacoemulsification and vision improved within the first few postoperative days. However, visual loss with an anterior chamber reaction of ++++ and a ++ vitreous cell were noted in the 4th postoperative week. Repeated intravitreal injection of vancomycin and ceftriaxone, pars plana vitrectomy and removal of the intraocular lens (IOL), and the capsular bag were performed sequentially but in vain. Bacterial, mycobacterial, and fungal culture of the IOL and capsular bag demonstrated negative findings. Pathological examination revealed no pathogen but a number of mononuclear cells and several multinuclear giant cells. Serology exam revealed positive herpes simplex virus immunoglobulin (Ig)M and IgG. The intraocular inflammation resolved soon after changing antibiotics to oral valcyclovir.