Endogenous Bacterial Endophthalmitis Secondary to Prosthetic Vascular Graft Infection

Prosthetic vascular graft infection is a rare but serious complication that can cause bloodstream dissemination and bacterial endophthalmitis. We report the case of a 79-year-old woman who experienced bacterial endophthalmitis secondary to thoracic aortic graft infection. She had previously undergone ascending aortic replacement and later total aortic arch replacement with sinutubular junction plication. She presented with persistent fever, visual floaters, and decreased vision in her left eye. Blood cultures grew Streptococcus agalactiae, and computed tomography showed periprosthetic air consistent with graft infection. Ophthalmologic examination confirmed bacterial endophthalmitis. Systemic antibiotics and intravitreal injections were administered, followed by valve-sparing aortic root replacement using a rifampicin-soaked graft and later vitrectomy. The postoperative course was favorable, with recovery of visual function. Bacterial endophthalmitis secondary to prosthetic graft infection is extremely rare, and early diagnosis with multidisciplinary management is essential for visual and systemic recovery.