A Case of Streptococcus dysgalactiae Endophthalmitis after Cataract Surgery

Jun Min Park; Myeong In Yeom; Jung Min Park

doi:10.3341/jkos.2018.59.2.185

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Park, Yeom, and Park: A Case of Streptococcus dysgalactiae Endophthalmitis after Cataract Surgery

Case Report

Journal of the Korean Ophthalmological Society 2018; 59(2): 185-189.

Published online: 9 February 2018

DOI: https://doi.org/10.3341/jkos.2018.59.2.185

A Case of Streptococcus dysgalactiae Endophthalmitis after Cataract Surgery

Jun Min Park, MD, Myeong In Yeom, MD, Jung Min Park, MD, PhD

Department of Ophthalmology, Maryknoll Medical Center, Busan, Korea.

Address reprint requests to Jung Min Park, MD, PhD. Department of Ophthalmology, Maryknoll Medical Center, #121 Junggu-ro, Jung-gu, Busan 48972, Korea. Tel: 82-51-461-2540, Fax: 82-51-465-7470, pjm1438@hanmail.net

Received 9 November 2017 Revised 5 December 2017 Accepted 25 January 2018

The Korean Ophthalmological Society

(open-access):

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 endophthalmitis due to Streptococcus dysgalactiae after phacoemulsification and posterior chamber intraocular lens implantation in the Republic of Korea.

Case summary

A 65-year-old male was transferred because of endophthalmitis following cataract surgery. His initial visual acuity was light perception. Because inflammation of the anterior chamber and vitreous cavity progressed rapidly, we performed total pars planar vitrectomy and intraocular lens extraction in addition to administering intravitreal antibiotics and intravitreal dexamethasone injections. Streptococcus dysgalactiae was identified in samples cultured from the vitreous and anterior chamber fluid. Four days after surgery, we washed the anterior chamber and intravitreal antibiotics were again injected because of increased inflammation of the anterior chamber and vitreous. The patient was discharged 25 days after surgery but corneal neovascularization, contraction, edema, infiltration, and hypopyon remained. Visual acuity progressed to no light perception and there was shrinkage of the globe.

Conclusions

Endophthalmitis due to Streptococcus dysgalactiae is very rare. We report the first case of endophthalmitis caused by Streptococcus dysgalactiae in the Republic of Korea. The prognosis for recovery was poor despite aggressive treatment.

Keywords: Cataract surgery, Endophthalmitis, Group G streptococcus, Streptococcus dysgalactiae

Figures and Tables

Figure 1

Anterior segment photograph and ultrasonogram at the initial presentation. Anterior segment photography at first visit (A) Diffuse corneal edema and dense peripheral corneal infiltration and exudates in the anterior chamber. (B) Ultrasound B scan revealed the presence of dense vitreous infiltration.

Figure 2

Anterior segment photograph and ultrasonogram at 4 days after surgery. (A) Diffuse corneal infiltration and total hypopyon in the anterior chamber. (B) Dense vitreous infiltration increased in the ultrasound B scan.

Figure 3

Anterior segment photograph at 3 weeks after discharge. Peripheral corneal neovascularization and decreased corneal size.

Notes

This study was presented as an e-poster at the 115th Annual Meeting of the Korean Ophthalmological Society 2016.

^{Conflicts of Interest} The authors have no conflicts to disclose.

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