A Case of Raoultella planticola Endophthalmitis after Cataract Surgery

Jayoung Ahn; Hyoun Do Huh; Mingui Kong; In Young Chung; Jong Moon Park; Yong Seop Han

doi:10.3341/jkos.2016.57.10.1651

Journal List > J Korean Ophthalmol Soc > v.57(10) > 1010436

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Ahn, Huh, Kong, Chung, Park, and Han: A Case of Raoultella planticola Endophthalmitis after Cataract Surgery

Case Report

J Korean Ophthalmol Soc 2016;57(10):1651-1655.

Published online: 25 September 2016

DOI: https://doi.org/10.3341/jkos.2016.57.10.1651

A Case of Raoultella planticola Endophthalmitis after Cataract Surgery

Jayoung Ahn, MD¹, Hyoun Do Huh, MD², Mingui Kong, MD^1,³, In Young Chung, MD, PhD^1,³, Jong Moon Park, MD, PhD^1,^2,³, Yong Seop Han, MD, PhD^1,³

¹Department of Ophthalmology, Gyeongsang National University College of Medicine, Jinju, Korea

²Department of Ophthalmology, Gyeongsang National University Changwon Hospital, Changwon, Korea

³Gyeongsang Institute of Health Science, Gyeongsang National University, Jinju, Korea

Address reprint requests to Yong Seop Han, MD, PhD Department of Ophthalmology, Gyeongsang National University Hospital, #79 Gangnam-ro, Jinju 52727, Korea Tel: 82-55-750-8181, Fax: 82-55-758-4158 E-mail: medcabin@hanmail.net

Received 23 June 2016 Accepted 23 September 2016

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 the first case of the Raoultella planticola endophthalmitis after the phacoemulsification and posterior chamber multi-focused intraocular lens (IOL) implantation.

Case summary

A healthy 49-year-old male visited our clinic with a sudden visual disturbance and ocular pain 2 days after phacoemulsification and multi-focused IOL implantation in his right eye. On initial ophthalmic examination, severe corneal edema and hypopyon were observed. The retina could not be visualized due to vitreous opacity and anterior chamber inflammation. Therefore, the patient immediately underwent pars plana vitrectomy. Vancomycin hydrogen chloride (HCl) 0.3 mg/0.1 mL was injected into the anterior part and vancomycin HCl 1.0 mg/0.1 mL and ceftazidime 2.0 mg/0.1 mL were injected into the intravitreal part. The culture test of aqueous humor and vitreous body fluid revealed Raoultella planticola, thus, systemic antibiotic (ceftazidime) and antibiotic eye drops (vancomycin and ceftazidime) were administered. After 4 months of follow-up, best-cor-rected visual acuity improved to 20/20 in the affected eye after surgery.

Conclusions

In the present case, we found that endophthalmitis due to Raoultella planticola can be successfully treated. We suggest that atypical bacteria should be considered in the differential diagnosis of endophthalmitis after cataract surgery.

Keywords: Cataract surgery, Endophthalmitis, Raoultella planticola

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Figure 1.

Anterior segment photograph and ultrasonogram at the the initial presentation. (A) Conjunctival injection, corneal edema and hypopyon were identified. (B) Heterogeneous vitreous opacity was observed.

Figure 2.

Culture of aqueous humor and vitreous. (A) Pink‐ colored cottony colony on MacConkey agar after incubation. (B) Microscopic morphology of Raoultella planticola (Gram stain, ×1,000). (C) Scanning electron microscopy of Raoultella planticola.

Figure 3.

Anterior segment photograph. (A) Slight corneal edema and no hypopyon were identified at 10 days after surgery. (B) Clear cornea and no inflammation were observed at 4 months after surgery.

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