J Korean Ophthalmol Soc.  2018 Feb;59(2):185-189. 10.3341/jkos.2018.59.2.185.

A Case of Streptococcus dysgalactiae Endophthalmitis after Cataract Surgery

• Park JM
• Yeom MI
• Park JM

• KMID: 2403814
• DOI: http://doi.org/10.3341/jkos.2018.59.2.185

Abstract

PURPOSE
To report the first case of endophthalmitis due to Streptococcus dysgalactiae after phacoemulsification and posterior chamber intraocular lens implantation in the Republic of Korea.
CASE SUMMARY
A 65-year-old male was transferred because of endophthalmitis following cataract surgery. His initial visual acuity was light perception. Because inflammation of the anterior chamber and vitreous cavity progressed rapidly, we performed total pars planar vitrectomy and intraocular lens extraction in addition to administering intravitreal antibiotics and intravitreal dexamethasone injections. Streptococcus dysgalactiae was identified in samples cultured from the vitreous and anterior chamber fluid. Four days after surgery, we washed the anterior chamber and intravitreal antibiotics were again injected because of increased inflammation of the anterior chamber and vitreous. The patient was discharged 25 days after surgery but corneal neovascularization, contraction, edema, infiltration, and hypopyon remained. Visual acuity progressed to no light perception and there was shrinkage of the globe.
CONCLUSIONS
Endophthalmitis due to Streptococcus dysgalactiae is very rare. We report the first case of endophthalmitis caused by Streptococcus dysgalactiae in the Republic of Korea. The prognosis for recovery was poor despite aggressive treatment.

Keyword

Cataract surgery; Endophthalmitis; Group G streptococcus; Streptococcus dysgalactiae

MeSH Terms

Aged
Anterior Chamber
Anti-Bacterial Agents
Cataract*
Corneal Neovascularization
Dexamethasone
Edema
Endophthalmitis*
Humans
Inflammation
Lens Implantation, Intraocular
Lenses, Intraocular
Male
Phacoemulsification
Prognosis
Republic of Korea
Streptococcus*
Visual Acuity
Vitrectomy
Anti-Bacterial Agents
Dexamethasone

Figure

• 

  Figure 1 Anterior segment photograph and ultrasonogram at the initial presentation. Anterior segment photography at first visit (A) Diffuse corneal edema and dense peripheral corneal infiltration and exudates in the anterior chamber. (B) Ultrasound B scan revealed the presence of dense vitreous infiltration.

• 

  Figure 2 Anterior segment photograph and ultrasonogram at 4 days after surgery. (A) Diffuse corneal infiltration and total hypopyon in the anterior chamber. (B) Dense vitreous infiltration increased in the ultrasound B scan.

• 

  Figure 3 Anterior segment photograph at 3 weeks after discharge. Peripheral corneal neovascularization and decreased corneal size.

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