Endogenous endophthalmitis by Enterococcus casseliflavus in an apparently healthy individual

Endogenous endophthalmitis (EE) is usually encountered in immunocompromised individuals due to various causes and usually follows a systemic septic focus. Here, we describe Enterococcus casseliflavus-induced EE in an otherwise healthy individual in his early 30s, who had no prior history of trauma, hospitalisation or immune deficiency. The patient presented with acute, unilateral, painful visual loss associated with redness. Despite undergoing vitrectomy and receiving intravitreal injections of vancomycin and ceftazidime, the patient showed limited clinical improvement. Oral linezolid and intravitreal teicoplanin were administered following the antibiotic culture and the sensitivity findings from the vitreous biopsy and aqueous tap. Three weeks following the vitrectomy, the patient's visual acuity improved to 20/200, with no signs of disease recurrence. This report highlights the rarity of E. casseliflavus in causing endophthalmitis in a healthy individual with no systemic septic focus and the efficacy of Teicoplanin against it.