Exogenous endophthalmitis caused by Enterococcus casseliflavus:A case report  

作　　者：Qing-Dong Bao Tai-Xiang Liu Meng Xie Xiang Tian 

机构地区：[1]Department of Ophthalmology, Affiliated Hospital of Zunyi Medical University

出　　处：《World Journal of Clinical Cases》2019年第22期3904-3911,共8页世界临床病例杂志

基　　金：Supported by National Natural Science Foundation of China,No.81660169

摘　　要：BACKGROUND Endophthalmitis caused by Enterococci is rare,and cases involving vancomycinresistant enterococci are even rarer.We report the first case of Enterococcus casseliflavus endophthalmitis associated with injury caused by a pig.We also review reported cases of exogenous endophthalmitis caused by Enterococcus casseliflavus and discuss the clinical management and prognosis of this disease.CASE SUMMARY A 43-year-old man with no previous visual problems complained of endophthalmitis in his left eye following injury caused by a pig.Visual acuity was light perception and B-ultrasonography revealed vitreous opacities with retinal detachment.He was treated with intravitreal vancomycin and ceftazidime after refusing vitrectomy.However,the vitreous opacities and retinal detachment deteriorated and he underwent vitrectomy 5 d post-injury.Intraoperatively,advanced rhegmatogenous and tractional retinal detachment with proliferative vitreoretinopathy were observed.On postoperative day 5,vitreous cultures grew Gram-positive cocci identified as Enterococcus casseliflavus.A 2-wk course of intravenous ampicillin and dexamethasone was commenced.On postoperative day 14,visual acuity improved to hand movement.At 6 mo post-injury,visual acuity improved to 20/667,but optic atrophy was present.CONCLUSION Systemic administration of linezolid in the treatment of Enterococcus casseliflavus endophthalmitis can improve visual acuity.However,intravitreal amikacin should be considered despite concerns of toxicity when oral linezolid fails to prompt improvement.BACKGROUND Endophthalmitis caused by Enterococci is rare, and cases involving vancomycinresistant enterococci are even rarer. We report the first case of Enterococcus casseliflavus endophthalmitis associated with injury caused by a pig. We also review reported cases of exogenous endophthalmitis caused by Enterococcus casseliflavus and discuss the clinical management and prognosis of this disease.CASE SUMMARY A 43-year-old man with no previous visual problems complained of endophthalmitis in his left eye following injury caused by a pig. Visual acuity was light perception and B-ultrasonography revealed vitreous opacities with retinal detachment. He was treated with intravitreal vancomycin and ceftazidime after refusing vitrectomy. However, the vitreous opacities and retinal detachment deteriorated and he underwent vitrectomy 5 d post-injury. Intraoperatively,advanced rhegmatogenous and tractional retinal detachment with proliferative vitreoretinopathy were observed. On postoperative day 5, vitreous cultures grew Gram-positive cocci identified as Enterococcus casseliflavus. A 2-wk course of intravenous ampicillin and dexamethasone was commenced. On postoperative day 14, visual acuity improved to hand movement. At 6 mo post-injury, visual acuity improved to 20/667, but optic atrophy was present.CONCLUSION Systemic administration of linezolid in the treatment of Enterococcus casseliflavus endophthalmitis can improve visual acuity. However, intravitreal amikacin should be considered despite concerns of toxicity when oral linezolid fails to prompt improvement.

关 键 词：Vancomycin-resistant ENTEROCOCCI ENTEROCOCCUS casseliflavusendophthalmitis Treatment Case report 

分 类 号：TP3[自动化与计算机技术—计算机科学与技术]