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HYPERACUTE CUTIBACTERIUM ACNES ENDOPHTHALMITIS AFTER CATARACT SURGERY
Blake M Hauser1, Sandra Hoyek2, Scott H Greenstein2
1Harvard Medical School, Boston, Massachusetts; and.
Purpose:
Postoperative endophthalmitis is a relatively uncommon, but potentially visually devastating, complication associated with cataract surgery. Specific microbial causes of endophthalmitis are characteristically associated with particular disease time courses. Although Cutibacterium acnes is typically associated with an indolent course of inflammation, we report a case of C. acnes endophthalmitis with onset on postoperative day (POD) 1 and a positive culture from POD 2.
Methods:
This is a case report.
Results:
A 56-year-old man underwent cataract extraction and posterior chamber intraocular lens placement in his left eye. On POD 1, he presented with severe discomfort, reduced visual acuity, and significant inflammation. On POD 2, his anterior chamber was tapped and injected with broad-spectrum antibiotics and steroids. The inflammation ultimately resolved, and his visual acuity improved to 20/20.
Conclusion:
C. acnes is a rare cause of hyperacute-onset postoperative endophthalmitis. Maintaining a high clinical suspicion and initiating prompt treatment can help to optimize long-term visual outcomes.
Insights
A rare case of Cutibacterium acnes endophthalmitis presented hyperacutely after cataract surgery. Prompt diagnosis and treatment led to improved visual outcomes, challenging typical C. acnes infection timelines.
Area of Science:
- Ophthalmology
- Infectious Diseases
Background:
- Postoperative endophthalmitis is a severe complication following cataract surgery.
- The causative microbe often dictates the clinical presentation and timeline of endophthalmitis.
Purpose of the Study:
- To report a case of Cutibacterium acnes endophthalmitis with an unusually rapid onset.
- To highlight the importance of considering C. acnes in hyperacute endophthalmitis.
Main Methods:
- Case report detailing a patient who underwent cataract extraction.
- Clinical presentation, diagnostic procedures, and treatment of endophthalmitis were documented.
Main Results:
- The patient presented with severe symptoms and inflammation on postoperative day 1.
- Cultures confirmed Cutibacterium acnes as the causative agent.
- Treatment with antibiotics and steroids resulted in resolution of inflammation and improved visual acuity to 20/20.
Conclusions:
- Cutibacterium acnes can cause hyperacute postoperative endophthalmitis, deviating from its typical indolent course.
- Early clinical suspicion and prompt intervention are crucial for favorable visual prognoses in endophthalmitis.
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