Streptococcus salivarius endogenous endophthalmitis

BMJ Case Rep. 2021 Feb 4;14(2):e239299. doi: 10.1136/bcr-2020-239299.

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.

Keywords: infectious diseases; ophthalmology; retina.

Publication types

  • Case Reports

MeSH terms

  • Abscess / surgery
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use*
  • Ceftazidime / therapeutic use*
  • Endophthalmitis / microbiology*
  • Eye Infections, Bacterial / drug therapy*
  • Eye Infections, Bacterial / microbiology
  • Humans
  • Male
  • Streptococcus salivarius / isolation & purification*
  • Ultrasonography
  • Vancomycin / therapeutic use*
  • Vitrectomy*
  • Vitreous Body / microbiology

Substances

  • Anti-Bacterial Agents
  • Vancomycin
  • Ceftazidime