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<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.0 20120330//EN" "JATS-journalpublishing1.dtd">
<article article-type="case-report" dtd-version="1.0" xml:lang="en" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">JKOS</journal-id>
<journal-title-group>
<journal-title>Journal of the Korean Ophthalmological Society</journal-title>
<abbrev-journal-title>J Korean Ophthalmol Soc</abbrev-journal-title>
</journal-title-group>
<issn pub-type="ppub">0378-6471</issn>
<issn pub-type="epub">2092-9374</issn>
<publisher>
<publisher-name>Korean Ophthalmological Society</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3341/jkos.2016.57.6.999</article-id>
<article-id pub-id-type="publisher-id">jkos-57-999</article-id>
<article-categories>
<subj-group>
<subject>Case Report</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>A Case of <italic>Staphylococcus lugdunensis</italic> Endophthalmitis after Cataract Surgery</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name name-style="western" xml:lang="en"><surname>Han</surname><given-names>Sang Youn</given-names></name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="aff1-jkos-57-999"/>
</contrib>
<contrib contrib-type="author">
<name name-style="western" xml:lang="en"><surname>Lee</surname><given-names>Tae Gon</given-names></name>
<degrees>MD, PhD</degrees>
<xref ref-type="corresp" rid="c1-jkos-57-999"/>
<xref ref-type="aff" rid="aff1-jkos-57-999"/>
</contrib>
<aff id="aff1-jkos-57-999">Myunggok Eye Research Center, Department of Ophthalmology, Kim&#x0027;s Eye Hospital, Konyang University College of Medicine, Seoul, <country>Korea</country></aff>
</contrib-group>
<author-notes>
<corresp id="c1-jkos-57-999">Address reprint requests to <bold>Tae Gon Lee, MD, PhD</bold> Kim&#x0027;s Eye Hospital, &#x0023;136 Yeongsin-ro, Yeongdeungpo-gu, Seoul 07301, Korea Tel: 82-2-2639-7811, Fax: 82-2-2639-9214 E-mail: <email>idoc@kimeye.com</email></corresp>
</author-notes>
<pub-date pub-type="ppub">
<month>09</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>25</day>
<month>09</month>
<year>2016</year>
</pub-date>
<volume>57</volume><issue>6</issue>
<fpage>999</fpage>
<lpage>1003</lpage>
<history>
<date date-type="received"><day>03</day><month>07</month><year>2015</year></date>
<date date-type="rev-recd"><day>09</day><month>09</month><year>2015</year></date>
<date date-type="accepted"><day>29</day><month>10</month><year>2015</year></date>
</history>
<permissions>
<copyright-statement>Copyright &#x00A9; 2016 Korean Ophthalmological Society</copyright-statement>
<copyright-year>2016</copyright-year>
<license><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">http://creativecommons.org/licenses/by-nc/3.0/</ext-link>) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license>
</permissions>
<abstract xml:lang="en">
<title>Abstract</title>
<sec>
<title>Purpose</title>
<p>To report a case of <italic>Staphylococcus lugdunensis</italic> endophthalmitis following cataract extraction and intraocular lens implantation.</p>
</sec>
<sec><title>Case summary</title>
<p>A 59-year-old woman presented with unilateral vision impairment and eyeball pain in her left eye, thirteen days after phacoemulsification and posterior chamber intraocular lens implantation. Best-corrected visual acuity of her left eye was 20/200. Slit lamp examination of her left eye revealed a severe conjunctival injection, severe chamber reactions with exudative membranes, hypopyon (about 1 mm) in the anterior chamber, and the fundus was not visible. Before the patient was admitted to the hospital, we cultured samples of aqueous fluid and performed an intravitreal antibiotics injection (vancomycin 1.0 mg/0.1 mL, ceftazidime 2.0 mg/0.1 mL). However, on the next day, because the inflammatory reactions of the anterior chamber and vitreous cavity were not improved and Gram positive cocci was confirmed, we performed a pars plana vitrectomy and an additional intravitreal antibiotics injection (vancomycin 1.0 mg/0.1 mL, dexamethasone 0.5 mg/0.1 mL). Seven days after the surgery, <italic>Staphylococcus lugdunensis</italic> was identified in the aqueous fluids culture. 11 days after the surgery, her inflammation and symptoms were improved and therefore, she could be discharged. Three months after the surgery, best-corrected visual acuity of her left eye was 20/20 and there was no evidence of recurrence of endophthalmitis and no abnormal findings in her fundus.</p>
</sec>
</abstract>
<kwd-group xml:lang="en">
<kwd>Cataract surgery</kwd>
<kwd>Endophthalmitis</kwd>
<kwd>Postoperative endophthalmitis</kwd>
<kwd><italic>Staphylococcus lugdunensis</italic></kwd>
</kwd-group>
</article-meta>
</front>
<back>
<ref-list>
<title>References</title>
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</ref-list>
<sec sec-type="display-objects">
<title>Figures and Tables</title>
<fig id="f1-jkos-57-999" position="anchor">
<label>Figure 1.</label>
<caption xml:lang="en"><p>Pre- and intraoperative findings. (A) Just before vitrectomy, anterior segment shows severe conjunctival injection and hypopyon. (B) Thick, exudative membranes were found in anterior chamber.</p></caption>
<graphic xlink:href="jkos-57-999f1.tif"/>
</fig>
<fig id="f2-jkos-57-999" position="anchor">
<label>Figure 2.</label>
<caption xml:lang="en"><p>Intraoperative fundus finding. At the end of vitrectomy, there was no inflammation or retinal hemorrhages on her left fundus.</p></caption>
<graphic xlink:href="jkos-57-999f2.tif"/>
</fig>
<fig id="f3-jkos-57-999" position="anchor">
<label>Figure 3.</label>
<caption xml:lang="en"><p>Postoperative fundus finding. At 3 months after vitrectomy, there was no inflammation or infection signs on fundus photo.</p></caption>
<graphic xlink:href="jkos-57-999f3.tif"/>
</fig>
<fig id="f4-jkos-57-999" position="anchor">
<label>Figure 4.</label>
<caption xml:lang="en"><p>Anterior segment photography. Anterior segment photography on 3 months postoperative day shows clear cornea, normal anterior chamber, and posterior capsular intraocular lens was in place.</p></caption>
<graphic xlink:href="jkos-57-999f4.tif"/>
</fig>
<table-wrap id="t1-jkos-57-999" position="float">
<label>Table 1.</label>
<caption xml:lang="en"><p>The result of antibiotic sensitivity test of <italic>Staphylococcus lugdunensis</italic></p></caption>
<table frame="hsides" rules="all">
<thead>
<tr>
<th valign="middle" align="left">Antibiotics</th>
<th valign="middle" align="center">Sensitivity</th>
</tr>
</thead>
<tbody>
<tr>
<td valign="middle" align="left">Ciprofloxacin</td>
<td valign="middle" align="center">Sensitive</td>
</tr>
<tr>
<td valign="middle" align="left">Clindamycin</td>
<td valign="middle" align="center">Sensitive</td>
</tr>
<tr>
<td valign="middle" align="left">Erythromycin</td>
<td valign="middle" align="center">Sensitive</td>
</tr>
<tr>
<td valign="middle" align="left">Fusidic acid</td>
<td valign="middle" align="center">Sensitive</td>
</tr>
<tr>
<td valign="middle" align="left">Gentamycin</td>
<td valign="middle" align="center">Sensitive</td>
</tr>
<tr>
<td valign="middle" align="left">Habekacin</td>
<td valign="middle" align="center">Sensitive</td>
</tr>
<tr>
<td valign="middle" align="left">Linezolid</td>
<td valign="middle" align="center">Sensitive</td>
</tr>
<tr>
<td valign="middle" align="left">Nitrofurantoin</td>
<td valign="middle" align="center">Sensitive</td>
</tr>
<tr>
<td valign="middle" align="left">Oxacillin</td>
<td valign="middle" align="center">Sensitive</td>
</tr>
<tr>
<td valign="middle" align="left">Penicillin G</td>
<td valign="middle" align="center">Resistant</td>
</tr>
<tr>
<td valign="middle" align="left">Quinupristin/dalfopristin</td>
<td valign="middle" align="center">Sensitive</td>
</tr>
<tr>
<td valign="middle" align="left">Rifampin</td>
<td valign="middle" align="center">Sensitive</td>
</tr>
<tr>
<td valign="middle" align="left">Teicoplanin</td>
<td valign="middle" align="center">Sensitive</td>
</tr>
<tr>
<td valign="middle" align="left">Telithromycin</td>
<td valign="middle" align="center">Sensitive</td>
</tr>
<tr>
<td valign="middle" align="left">Tetracycline</td>
<td valign="middle" align="center">Resistant</td>
</tr>
<tr>
<td valign="middle" align="left">Trimethoprim/sulfamethoxazole</td>
<td valign="middle" align="center">Sensitive</td>
</tr>
<tr>
<td valign="middle" align="left">Vancomycin</td>
<td valign="middle" align="center">Sensitive</td>
</tr>
</tbody>
</table>
</table-wrap>
</sec>
</back>
</article>
