J Korean Ophthalmol Soc.  2019 Oct;60(10):1006-1009. 10.3341/jkos.2019.60.10.1006.

Anterior Uveitis Caused by Listeria Monocytogenes Infection

• Kim YM
• Jung JU
• Kang YK
• Park DH
• Shin JP

• KMID: 2460521
• DOI: http://doi.org/10.3341/jkos.2019.60.10.1006

Abstract

PURPOSE
To report a case of anterior uveitis secondary to Listeria monocytogenes infection.
CASE SUMMARY
A 57-year-old male presented to our clinic with ocular pain and decreased vision in the right eye for 2 days. The patient had a history of liver transplantation 2 years prior and used immunosuppressive agents. Listeria monocytogenes was identified in blood cultures 1 month before his visit. At presentation, best-corrected visual acuity (BCVA) of the right eye was counting fingers at 20 cm and the intraocular pressure (IOP) was 50 mmHg. Conjunctival hyperemia, corneal edema, keratic precipitates, and cells in the anterior chamber were observed in the right eye. The patient was diagnosed as anterior uveitis in the right eye. Conventional uveitis treatment was initiated but clinical features did not improve and black hypopyon appeared. The possibility of anterior uveitis caused by Listeria monocytogenes infection was considered. An anterior chamber tap and culture were conducted to identify pathogens. Anterior chamber antibiotic injections and systemic antibiotic injections were performed. One week after injection, the BCVA of the right eye improved to 0.4 and the IOP decreased to 14 mmHg. One month after injection, the BCVA of the right eye improved to 1.0 and the IOP decreased to 16 mmHg. No inflammation of the anterior chamber was observed.
CONCLUSIONS
When nonspecific uveitis occurs in immunosuppressed patients, cultures and appropriate antibiotics should be considered because of the possibility of infection.

Keyword

Dark hypopyon; Endophthalmitis; Listeria monocytogenes; Uveitis

MeSH Terms

Anterior Chamber
Anti-Bacterial Agents
Corneal Edema
Endophthalmitis
Fingers
Humans
Hyperemia
Immunosuppressive Agents
Inflammation
Intraocular Pressure
Listeria monocytogenes*
Listeria*
Liver Transplantation
Male
Middle Aged
Uveitis
Uveitis, Anterior*
Visual Acuity
Anti-Bacterial Agents
Immunosuppressive Agents

Figure

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  Figure 1 Anterior segment photography at the initial visit. (A) Conjunctival injection was seen in the right eye. (B) Diffuse corneal edema and anterior chamber cells were seen in the right eye. (C) Keratic precipitates were observed in the right eye.

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  Figure 2 Anterior segment photography of right eye at one day after the initial visit. Black hypopyon (arrow) was observed.

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