Recurrence of bacterial endophthalmitis after penetrating keratoplasty

• Published in: Archivos de la Sociedad Española de Oftalmología Vol. 79; no. 2; pp. 89 - 92
• Main Authors: García Serrano, J L, Domínguez, I, Serrano Laborda, D
• Format: Journal Article
• Language: Spanish
• Published: Spain 01.02.2004
• Subjects: Abscess - diagnosis; Abscess - drug therapy; Abscess - microbiology; Adult; Amphotericin B - therapeutic use; Aqueous Humor - microbiology; Candida albicans - isolation & purification; Candidiasis - diagnosis; Candidiasis - drug therapy; Candidiasis - microbiology; Ciprofloxacin - therapeutic use; Drug Therapy, Combination - therapeutic use; Endophthalmitis - diagnosis; Endophthalmitis - drug therapy; Endophthalmitis - microbiology; Eye Infections, Bacterial - diagnosis; Eye Infections, Bacterial - drug therapy; Eye Infections, Bacterial - microbiology; Eye Infections, Fungal - diagnosis; Eye Infections, Fungal - drug therapy; Eye Infections, Fungal - microbiology; Humans; Keratoplasty, Penetrating; Male; Postoperative Complications; Recurrence; Staphylococcal Infections - diagnosis; Staphylococcal Infections - drug therapy; Staphylococcal Infections - microbiology; Staphylococcus aureus - isolation & purification; Treatment Outcome; Vancomycin - therapeutic use; Vitreous Body - microbiology
• ISSN: 0365-6691

One month after penetrating keratoplasty, a male patient suffered recurrent abscess and endophthalmitis caused by mixed bacteria (Staphylococcus aureus and Candida Albicans). Two samples of vitreous and aqueous were taken, and a combination of systemic Vancomycin and Amphotericin B were injected intravitreally. The patient was asymptomatic for a month, but the abscess reactivated and was treated with Vancomycin and Ciprofloxacin administered intravenously. Fifteen days after withdrawing the treatment endophthalmitis returned and was treated with vitrectomy and additional systemic/intravitreal antibiotics and antifungal therapy. The final visual acuity was 20/40. The delayed vitrectomy proved to be necessary to remove established germs and to eliminate recurrent infections.