Journal List > J Korean Ophthalmol Soc > v.57(6) > 1010622

Han and Lee: A Case of Staphylococcus lugdunensis Endophthalmitis after Cataract Surgery

Abstract

Purpose

To report a case of Staphylococcus lugdunensis endophthalmitis following cataract extraction and intraocular lens implantation.

Case summary

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, Staphylococcus lugdunensis 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.

References

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Figure 1.
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.
jkos-57-999f1.tif
Figure 2.
Intraoperative fundus finding. At the end of vitrectomy, there was no inflammation or retinal hemorrhages on her left fundus.
jkos-57-999f2.tif
Figure 3.
Postoperative fundus finding. At 3 months after vitrectomy, there was no inflammation or infection signs on fundus photo.
jkos-57-999f3.tif
Figure 4.
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.
jkos-57-999f4.tif
Table 1.
The result of antibiotic sensitivity test of Staphylococcus lugdunensis
Antibiotics Sensitivity
Ciprofloxacin Sensitive
Clindamycin Sensitive
Erythromycin Sensitive
Fusidic acid Sensitive
Gentamycin Sensitive
Habekacin Sensitive
Linezolid Sensitive
Nitrofurantoin Sensitive
Oxacillin Sensitive
Penicillin G Resistant
Quinupristin/dalfopristin Sensitive
Rifampin Sensitive
Teicoplanin Sensitive
Telithromycin Sensitive
Tetracycline Resistant
Trimethoprim/sulfamethoxazole Sensitive
Vancomycin Sensitive
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