Endogenous Streptococcus Anginosus Endophthalmitis in an Immunocompetent Young Adult
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Yes
Purpose
To report a case of slowly progressive endogenous endophthalmitis secondary to Streptococcus anginosus in an immunocompetent patient.
Methods
Descriptive case report.
Results
A 46-year-old teacher presented with a two-month history of right eye iritis. On examination, visual acuity was 20/60 with intraocular pressure of 6 mm Hg. There was a small layer of hypopyon with non-granulomatous anterior uveitis and vitritis. On funduscopy, fluffy white peripheral retinal and pre-retinal lesions were noted in the superonasal periphery.
Pars plana vitrectomy was performed. Culture and polymerase chain reaction of vitreous samples were positive for Streptococcus anginosus. Intravitreal and systemic antibiotic therapy was instituted. Work-up which included blood and urine cultures, chest x-ray, echocardiography, and abdominal ultrasound was unyielding. Subsequently and because of a persistent post-infectious inflammatory reaction, intravitreal and oral steroids were administered in addition to azathioprine later on. After one year of follow-up, visual acuity was 20/20 with a near vision of Jaeger 3+ and no signs of active uveitis were seen.
Conclusion
Streptococcus anginosus should be considered in the differential diagnosis of slowly progressive endophthalmitis also in immunocompetent patients.
Conflict of interest
No
Author 1
Last name
SANCHEZ
Initials of first name(s)
JM
Department
Ophthalmology
City
Jerusalem
Country
Israel
Author 2
Last name
Davila
Initials of first name(s)
M
Department
Ophthalmology
City
Jerusalem
Country
Israel
Author 3
Last name
Halpert
Initials of first name(s)
M
Department
Ophthalmology
City
Jerusalem
Country
Israel
Author 4
Last name
Amer
Initials of first name(s)
R
Department
Ophthalmology
City
Jerusalem
Country
Israel
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