Acute bilateral postoperative endophthalmitis in a HLA-DQ5-positive patient : Possible susceptibility to infections

• Published in: Ophthalmic surgery and lasers Vol. 32; no. 4; pp. 322 - 324
• Main Authors: NICOLI, Carlos L, WAINSZTEIN, Ricardo D
• Format: Journal Article
• Language: English
• Published: Thorofare, NJ Slack 01.07.2001
• Subjects: Acute Disease; Adult; Anti-Bacterial Agents - therapeutic use; Aqueous Humor - microbiology; Bacterial diseases; Bacterial diseases of the eye and orbit; Biological and medical sciences; Cataract Extraction; Endophthalmitis - drug therapy; Endophthalmitis - genetics; Endophthalmitis - microbiology; Eye Infections, Bacterial - drug therapy; Eye Infections, Bacterial - genetics; Eye Infections, Bacterial - microbiology; Female; Genetic Predisposition to Disease; Gram-Positive Bacterial Infections - drug therapy; Gram-Positive Bacterial Infections - genetics; Gram-Positive Bacterial Infections - microbiology; HLA-DQ Antigens - analysis; Human bacterial diseases; Humans; Infectious diseases; Lens Implantation, Intraocular; Medical sciences; Postoperative Complications - drug therapy; Postoperative Complications - microbiology; Propionibacterium acnes - isolation & purification; Staphylococcus epidermidis - isolation & purification; Vancomycin - therapeutic use; Human; HLA-System; Acute; Bilateral; Patient; Uvea disease; Infection; Eye; Eye disease; Staphylococcus epidermidis; Surgery; Risk factor; Propionibacteriaceae; Bacteria; Micrococcales; Complication; Actinomycetes; Micrococcaceae; Propionibacterium acnes; Endophtalmitis
• ISSN: 1082-3069

An unusual case of bilateral acute endophthalmitis in association with the HLA-DQ5 histocompatibility antigen is reported. A 35-year-old woman with high myopia and cataracts in both eyes underwent phacoemulsification procedures performed in separate sessions using different viscoelastic substances and following the same strict prophylactic measures. After each surgical procedure, she developed S. epidermidis acute endophthalmitis in the right eye and Propionibacterium acnes acute endophthalmitis in the left eye; both were successfully treated with capsular bag irrigation and intracameral vancomycin (1 mg/0.1 mL). She tested positive for the HLA-DQ5 (DQ1), DQ2 antigen. The question is raised as to whether the HLA-DQ5 histocompatibility antigen may be a predisposing factor for both staphylococcal and P. Acnes acute endophthalmitis. A multicenter prospective study is proposed to identify this HLA antigen in all patients scheduled for cataract surgery who have a history of postoperative endophthalmitis in the fellow eye.