Streptococcus salivarius endogenous endophthalmitis
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BMJ Publishing Group
Abstract
We describe a case of endogenous endophthalmitis in an elderly man caused by Streptococcus salivarius. An 88-year-old male patient with diabetes with iron deficiency anaemia and history of transcatheter aortic valve implantation presented with an insidious clinical picture of atraumatic endophthalmitis. No internal or external source could be identified. Diagnostic and therapeutic vitrectomy revealed papillomacular abscess and vitreous fluids grew S. €¯salivarius. Despite lack of an identifiable source of infection, a high index of suspicion for atypical presentations is required in patients with multiple comorbidities that could weaken their immune system towards opportunistic infections. Early detection, microbiological evaluation and prompt treatment are critical to avoid disastrous outcomes. While S.¯salivarius has been implicated in cases of exogenous endophthalmitis, this is the first reported case of endogenous endophthalmitis due to S. €¯salivarius. © 2021 BMJ Publishing Group. All rights reserved.
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Keywords
Infectious diseases, Ophthalmology, Retina, Abscess, Aged, 80 and over, Anti-bacterial agents, Ceftazidime, Endophthalmitis, Eye infections, bacterial, Humans, Male, Streptococcus salivarius, Ultrasonography, Vancomycin, Vitrectomy, Vitreous body, Carbomer, Cyclopentolate, Hyaluronic acid, Moxifloxacin, Antiinfective agent, Aged, Article, B scan, Blurred vision, Case report, Caucasian, Clinical article, Clinical assessment, Decision making, Eye pain, Filamentary keratitis, Follow up, Hospital admission, Human, Intraoperative period, Mouth hygiene, Pars plana vitrectomy, Polymerase chain reaction, Postoperative period, Retina hemorrhage, Transcatheter aortic valve implantation, Treatment outcome, Very elderly, Visual acuity, Bacterial eye infection, Echography, Isolation and purification, Microbiology