A Case of Corneal Perforation and IOL Prolapsed in Serratia Marcescens Endophthalmitis after Cataract Surgery

Yong Kyun Shin; Moo Hwan Chang; Sung Eun Kyung

doi:10.3341/jkos.2013.54.10.1605

Journal List > J Korean Ophthalmol Soc > v.54(10) > 1009516

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Shin, Chang, and Kyung: A Case of Corneal Perforation and IOL Prolapsed in Serratia Marcescens Endophthalmitis after Cataract Surgery

Original Article

J Korean Ophthalmol Soc 2013;54(10):1605-1609.

Published online: 3 September 2013

DOI: https://doi.org/10.3341/jkos.2013.54.10.1605

A Case of Corneal Perforation and IOL Prolapsed in Serratia Marcescens Endophthalmitis after Cataract Surgery

Yong Kyun Shin, MD, Moo Hwan Chang, MD, PhD, Sung Eun Kyung, MD, PhD

Department of Ophthalmology, Dankook University Medical College, Cheonan, Korea

Address reprint requests to Moo Hwan Chang, MD, PhD, Department of Ophthalmology, Dankook University Hospital, #20 Manghyang-ro, Dongnam-gu, Cheonan 330-715, Korea, Tel: 82-41-550-6497, Fax: 82-41-561-0137, E-mail: changmh@dankook.ac.kr

Received 18 January 2013 Revised 19 April 2013 Accepted 9 September 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report a case of Serratia marcescens endophthalmitis following phacoemulsification and posterior chamber intraocular lens implantation.

Case summary

A 64-year-old male with a history of diabetes, hypertension, cardiovascular disease was referred with right ocular pain and reduced vision 1 day after cataract surgery. On admission, hypopyon on anterior chamber by slit lamp examination and anterior vitreous was hazy according to ultrasonography. We immediately performed intravitreal antibiotics injection and microbiological analysis of anterior chamber and vitreous samples was performed. On day 3, persistent cornea stormal infiltration and cornea perforation were visible and the organism was identified as S. marsescens. Despite appropriate antibiotic treatment the eye continued to deteriorate.

Conclusions

S. marcescens endophthalmitis was diagnosed and treated immediately, but rapid progression and outcome were unsatisfactory.

Keywords: Endophthalmitis, Serratia marcescens

References

1. Kresloff MS, Castellarin AA, Zarbin MA. Endophthalmitis. Surv Ophthalmol. 1998; 43:193–224.

2. Shrader SK, Bank JD, Lauter CB, Murphy P. The clinical spectrum of endophthalmitis: incidence, predisposing factor, and features in-fluencing outcome. J Infect Dis. 1990; 162:115–20.

3. Gaughran ER. From supersitition to science: the history of a bacterium. Trans NY Acad Sci. 1969; 31:3–24.

4. Equi RA, Green WR. Endogenous Serratia marcescens endophthalmitis with dark hypopyon: a case report and review. Surv Ophthalmol. 2001; 46:259–68.

5. Jonson DH, Klein NC, Cunha BA. Postoperative Serratia marcescens endophthalmitis. Heart Lung. 1992; 21:300–2.

6. Shaarawy A, Meredith TA, Kincaid M. . Intraocular injection of ceftazidime. Retina. 1995; 15:433–8.

7. Endophthalmitis Vitrectomy Study Group. Results of the Endophthalmitis Vitrectomy Study: a randomized trial of immediate vitrectomy and intravenous antibiotics for the treatment of postoperative bacterial endophthalmitis. Arch Ophthalmol. 1995; 113:1479–96.

8. Alexandrakis G, Alfonso EC, Milller D. Shifting trends in bacterial keratitis in south Florida and emergind resistance to fluoroquinolones. Ophthalmology. 2000; 107:1497–502.

9. Lee SH, Woo SJ, Park JH. . Serratia marcescens endophthalmitis associated with intravitreal injections of bevacizumab. Eye (Lond). 2010; 24:226–32.

10. al hazzaa SA, Tabbara KF, Gammon JA. Pink hypopyon: a sign of Serratia marcescens endophthalmitis. Br J Ophthalmol. 1992; 76:764–5.

11. Lyerly D, Gray L, Kreger A. Characterization of rabbit corneal damage produced by Serratia keratitis and by a serratia perotease. Infect Immun. 1981; 33:927–32.

12. Choi SH, Kim YS, Chung JW. . Serratia bacteremia in a large university hospital: trends in antibiotic resistance during 10 years and implications for antibiotic use. Infect Control Hosp Epidemiolo. 2002; 23:740–7.

13. Kumar N, Grandhewar R, Khan MY. Serratia marcescens endophthalmitis after cataract surgery despite vancomycin and gentamicin in irrigation fluid. Can J Ophthalmol. 2004; 39:778–9.

14. Cohen SM, Flynn HW Jr, Miller D. Endophthalmitis caused by serratia marcescens. Ophthalmic Surg Lasers. 1997; 28:195–200.

Figure 1.

Photograph at the first visit. (A) Cornea was clear and sutured clear cornea incision was seen at temoral side of the right eye but severe flare and hypopyon in anterior chamber. (B) Ultrasonograph shows heterogenous vitreous opacity.

Figure 2.

Photograph at 4 days after admission. (A) Cornea was melted and conjunctiva was injection and chemosis of the right eye (B) Ultrasonograph shows dense vitreous opacity.

Figure 3.

(A) 14 days after admission, cornea was more thinning at temporal side of the right eye. (B) 30 days after admission, whole cornea was melted and globe was shrunken of the right eye.

TOOLS

Similar articles