Successful management of drug-resistant rhizobium radiobacter endophthalmitis: A case report

PurposeTo report a unique case of post-cataract surgery endophthalmitis caused by Ceftazidime-resistant Rhizobium radiobacter, successfully managed with timely vitrectomy and intravitreal LevofloxacinCase reportA healthy 73-year-old man underwent phacoemulsification and posterior chamber intraocular lens implantation in his left eye. Postoperative ocular examination (OE) one day after the surgery revealed no specific findings. However, on postoperative day 6, he presented with a painful and red left eye. Diagnosed with postoperative endophthalmitis on day 8 at another hospital, he received IVI of Ceftazidime and Vancomycin before being urgently referred to our hospital on the same day. Early vitrectomy and anterior chamber irrigation were performed timely when he arrived on day 8, with cultures identifying Ceftazidime-resistant Rhizobium radiobacter, sensitive to Levofloxacin. Repeated IVI of Levofloxacin (500 mcg/0.1 ml) ensued on post-cataract operative days 13 and 18. Six months post-cataract surgery, the corrected distance visual acuity of the left eye stabilized at 20/33, and OE remained stable.ConclusionEarly vitrectomy and vitreous culture prove effective in managing postoperative endophthalmitis in drug-resistant Rhizobium radiobacter. IVI of Levofloxacin, though rare, proved to be effective in treating Ceftazidime-resistant and Levofloxacin-sensitive pathogens in our case.