Streptococcus agalactiae Endophthalmitis in Boston Keratoprosthesis in a Patient with Steven-Johnson Syndrome

Middle East Afr J Ophthalmol. 2016 Oct-Dec;23(4):329-331. doi: 10.4103/0974-9233.194095.

Abstract

A 25-year-old Syrian male with a previous episode of Stevens-Johnson syndrome with bilateral corneal cicatrization previously underwent surgery for Type 1 Boston Keratoprosthesis (K-Pro). Sixteen months after the K-Pro surgery, the patient presented with decreased vision to hand motion and microbial keratitis of the graft around the K-Pro with purulent discharge. Corneal scrapings were nonrevealing. B-scan in 3 days showed increased debris in the vitreous cavity and thickened retinochoroidal layer. Intravitreal tap and injections of vancomycin and ceftazidime were performed. The vitreous culture revealed β-hemolytic Streptococcus agalactiae; fungal cultures were negative. Repeat B-scan 3 days later demonstrated decreased vitreous opacity, and the patient felt more comfortable and was without pain. His visual acuity improved to 20/70, ocular findings have been stable for 9 months, and the patient continues to be monitored.

Keywords: Boston Keratoprosthesis; Endophthalmitis; Steven–Johnson Syndrome; Streptococcus agalactiae.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Bioprosthesis*
  • Ceftazidime / therapeutic use
  • Cornea*
  • Corneal Ulcer / diagnosis
  • Corneal Ulcer / drug therapy
  • Corneal Ulcer / microbiology
  • Drug Combinations
  • Endophthalmitis / diagnosis
  • Endophthalmitis / drug therapy
  • Endophthalmitis / microbiology*
  • Eye Infections, Bacterial / diagnosis
  • Eye Infections, Bacterial / drug therapy
  • Eye Infections, Bacterial / microbiology*
  • Humans
  • Male
  • Prosthesis Implantation
  • Retrospective Studies
  • Stevens-Johnson Syndrome / surgery*
  • Streptococcal Infections / diagnosis
  • Streptococcal Infections / drug therapy
  • Streptococcal Infections / microbiology*
  • Streptococcus agalactiae / isolation & purification*
  • Vancomycin / therapeutic use
  • Vitreous Body / microbiology

Substances

  • Anti-Bacterial Agents
  • Drug Combinations
  • Vancomycin
  • Ceftazidime