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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

At follow-up after having undergone a tap and injection of vancomycin and ceftazidime, the hypopyon was larger. He was started on oral steroids
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Fig2: At follow-up after having undergone a tap and injection of vancomycin and ceftazidime, the hypopyon was larger. He was started on oral steroids

Mentions: Over the next few days, the hypopyon increased in size and oral prednisone was started (Fig. 2). Culture of the anterior chamber tap grew L. monocytogenes. Intravitreal amikacin was given upon result of the anterior chamber tap due to poor coverage of vancomycin for Listeria. An infectious disease consult was obtained; systemic antibiotic therapy was initiated including a 1-month course of intravenous 3 g ampicillin every 6 h and oral double-strength trimethoprim-sulfamethoxazole twice a day. Oral steroids were stopped, and fortified antibiotic drops were changed to topical gentamicin.Fig. 2


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)

At follow-up after having undergone a tap and injection of vancomycin and ceftazidime, the hypopyon was larger. He was started on oral steroids
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig2: At follow-up after having undergone a tap and injection of vancomycin and ceftazidime, the hypopyon was larger. He was started on oral steroids
Mentions: Over the next few days, the hypopyon increased in size and oral prednisone was started (Fig. 2). Culture of the anterior chamber tap grew L. monocytogenes. Intravitreal amikacin was given upon result of the anterior chamber tap due to poor coverage of vancomycin for Listeria. An infectious disease consult was obtained; systemic antibiotic therapy was initiated including a 1-month course of intravenous 3 g ampicillin every 6 h and oral double-strength trimethoprim-sulfamethoxazole twice a day. Oral steroids were stopped, and fortified antibiotic drops were changed to topical gentamicin.Fig. 2

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