Actinomyces israelii endogenous endophthalmitis

• Published in: British journal of ophthalmology Vol. 92; no. 3; pp. 427 - 428
• Main Authors: Milman, Tatyana, Mirani, Neena, Gibler, Therese, Van Gelder, Russell N, Langer, Paul D
• Format: Journal Article
• Language: English
• Published: BMA House, Tavistock Square, London, WC1H 9JR BMJ Publishing Group Ltd 01.03.2008; BMJ Publishing Group LTD
• Subjects: Actinomycosis - diagnosis; Aged; Diagnosis, Differential; Endophthalmitis - diagnosis; Eye Infections, Bacterial - diagnosis; Female; Humans; Organisms; Ribosomal DNA; New Jersey
• ISSN: 0007-1161; 1468-2079
• DOI: 10.1136/bjo.2007.123596

Diagnostic work-up included microbiological and cytological evaluation of two vitreous biopsies, and systemic investigation for a source of metastatic endophthalmitis (including whole-body positron emission tomography/computed tomography scan), all of which were negative. The implementation of PCR has allowed extremely sensitive and specific identification of Actinomyces species. 5 It is important to note, however, that ocular fluids may contain a naturally occurring PCR inhibitor yielding a false-negative PCR result. 6 In summary, Actinomyces should be considered in the differential diagnosis of endogenous endophthalmitis, especially in patients with a recent history of oral or dental manipulation.