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A case of Listeria monocytogenes endophthalmitis with recurrent inflammation and novel management.

Weber AC, Levison AL, Srivastava SK, Lowder CY - J Ophthalmic Inflamm Infect (2015)

Bottom Line: Listeria monocytogenes is a rare cause of endogenous endophthalmitis.An anterior chamber washout was necessary for the patient to regain 20/20 visual acuity.It also stresses the importance of addressing damaging inflammation in infectious conditions.

View Article: PubMed Central - PubMed

Affiliation: Cole Eye Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Mail Code i-32, Cleveland, OH, 44195, USA. webera2@ccf.org.

ABSTRACT

Background: Listeria monocytogenes is a rare cause of endogenous endophthalmitis. In the limited number of reported Listeria endophthalmitis cases, visual acuity outcomes have been very poor.

Findings: Here, we report a case of Listeria endophthalmitis that was complicated by recurrent inflammation. The patient required treatment with both intravitreal and long-term systemic antibiotics. An anterior chamber washout was necessary for the patient to regain 20/20 visual acuity.

Conclusions: This case highlights the importance of considering Listeria early in the disease course, as it has low sensitivity to standard empiric antibiotic therapy. It also stresses the importance of addressing damaging inflammation in infectious conditions.

No MeSH data available.


Related in: MedlinePlus

Photo documenting the development of a large hypopyon in the anterior chamber after having undergone a paracentesis
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Fig1: Photo documenting the development of a large hypopyon in the anterior chamber after having undergone a paracentesis

Mentions: The patient’s right eye was treated with maximum medical therapy for the intraocular pressure but failed to respond. An anterior chamber paracentesis was performed to lower his intraocular pressure, and he was continued on maximum IOP-lowering agents. On follow-up the next day, visual acuity was 20/70 and intraocular pressure was 43 mmHg in the right eye. The remainder of the exam was unchanged. The patient was started on valacyclovir 1 g three times a day and topical prednisolone acetate for presumed herpetic keratouveitis. The following day, a paracentral epithelial defect and a 4-mm hypopyon was seen (Fig. 1). B-scan ultrasound showed anterior vitritis. Anterior chamber tap was performed and intravitreal vancomycin and ceftazidime were injected for suspected infectious endophthalmitis. The patient was started on fortified vancomycin and ceftazidime drops as well.Fig. 1


A case of Listeria monocytogenes endophthalmitis with recurrent inflammation and novel management.

Weber AC, Levison AL, Srivastava SK, Lowder CY - J Ophthalmic Inflamm Infect (2015)

Photo documenting the development of a large hypopyon in the anterior chamber after having undergone a paracentesis
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4593987&req=5

Fig1: Photo documenting the development of a large hypopyon in the anterior chamber after having undergone a paracentesis
Mentions: The patient’s right eye was treated with maximum medical therapy for the intraocular pressure but failed to respond. An anterior chamber paracentesis was performed to lower his intraocular pressure, and he was continued on maximum IOP-lowering agents. On follow-up the next day, visual acuity was 20/70 and intraocular pressure was 43 mmHg in the right eye. The remainder of the exam was unchanged. The patient was started on valacyclovir 1 g three times a day and topical prednisolone acetate for presumed herpetic keratouveitis. The following day, a paracentral epithelial defect and a 4-mm hypopyon was seen (Fig. 1). B-scan ultrasound showed anterior vitritis. Anterior chamber tap was performed and intravitreal vancomycin and ceftazidime were injected for suspected infectious endophthalmitis. The patient was started on fortified vancomycin and ceftazidime drops as well.Fig. 1

Bottom Line: Listeria monocytogenes is a rare cause of endogenous endophthalmitis.An anterior chamber washout was necessary for the patient to regain 20/20 visual acuity.It also stresses the importance of addressing damaging inflammation in infectious conditions.

View Article: PubMed Central - PubMed

Affiliation: Cole Eye Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Mail Code i-32, Cleveland, OH, 44195, USA. webera2@ccf.org.

ABSTRACT

Background: Listeria monocytogenes is a rare cause of endogenous endophthalmitis. In the limited number of reported Listeria endophthalmitis cases, visual acuity outcomes have been very poor.

Findings: Here, we report a case of Listeria endophthalmitis that was complicated by recurrent inflammation. The patient required treatment with both intravitreal and long-term systemic antibiotics. An anterior chamber washout was necessary for the patient to regain 20/20 visual acuity.

Conclusions: This case highlights the importance of considering Listeria early in the disease course, as it has low sensitivity to standard empiric antibiotic therapy. It also stresses the importance of addressing damaging inflammation in infectious conditions.

No MeSH data available.


Related in: MedlinePlus