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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

Photos of the right and left eyes show the development of iris heterochromia due to shedding of iris pigment in the right eye, the infected eye
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Fig4: Photos of the right and left eyes show the development of iris heterochromia due to shedding of iris pigment in the right eye, the infected eye

Mentions: One month later, the patient’s visual acuity had returned to 20/20, intraocular pressure was 14 mmHg, and he was tapered off all medications and drops except trimethoprim-sulfamethoxazole. The patient developed another recurrence of iritis and was restarted on prednisolone acetate 1 %. Given the patient’s episodes of recurrent inflammation, he remains on prophylactic dosing of trimethoprim-sulfamethoxazole and prednisolone acetate 1 % daily. The patient was last seen 11 months after his initial presentation and was doing well with visual acuity 20/20 and on maintenance doses of daily 1 % prednisolone acetate and trimethoprim-sulfamethoxazole three times a week. The patient has developed heterochromia as a result of his Listeria endophthalmitis due to shedding of iris pigment in the infected eye (Fig. 4).Fig. 4


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)

Photos of the right and left eyes show the development of iris heterochromia due to shedding of iris pigment in the right eye, the infected eye
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig4: Photos of the right and left eyes show the development of iris heterochromia due to shedding of iris pigment in the right eye, the infected eye
Mentions: One month later, the patient’s visual acuity had returned to 20/20, intraocular pressure was 14 mmHg, and he was tapered off all medications and drops except trimethoprim-sulfamethoxazole. The patient developed another recurrence of iritis and was restarted on prednisolone acetate 1 %. Given the patient’s episodes of recurrent inflammation, he remains on prophylactic dosing of trimethoprim-sulfamethoxazole and prednisolone acetate 1 % daily. The patient was last seen 11 months after his initial presentation and was doing well with visual acuity 20/20 and on maintenance doses of daily 1 % prednisolone acetate and trimethoprim-sulfamethoxazole three times a week. The patient has developed heterochromia as a result of his Listeria endophthalmitis due to shedding of iris pigment in the infected eye (Fig. 4).Fig. 4

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