Acute postoperative Staphylococcus schleiferi endophthalmitis following uncomplicated cataract surgery: first report in the literature

Eur J Ophthalmol. May-Jun 2013;23(3):427-30. doi: 10.5301/ejo.5000254. Epub 2013 Mar 6.

Abstract

Introduction: We report a rare case of acute postoperative Staphylococcus schleiferi endophthalmitis following an uneventful cataract extraction.

Methods: An 83-year-old woman underwent uneventful phacoemulsification without receiving the usual intracameral cefuroxime solution due to cephalosporin intolerance. Two days postoperatively, she presented with acute ocular pain and blurred vision in the operated eye. Ophthalmic examination revealed signs of acute keratitis and endophthalmitis. Corneal scrapes and vitreous taps were sent for cultivation and analysis. The patient received intravitreal antibiotics at the same time.

Results: Cultivation grew S schleiferi, a pathogen commonly found in dogs. Following microbiological report, the patient received a repeated intravitreal injection of 1 mg/0.1 mL vancomycin combined with fortified topical vancomycin drops. One week later, the inflammation subsided completely while the corneal ulcer healed and visual acuity improved dramatically. Further examination revealed the existence of the same pathogen in a specimen obtained from the dog owned by the patient's family.

Conclusions: This description of S schleiferi endophthalmitis highlights the need to provide alternative intracameral antibiotic solution in the operating room and avoid direct contact with dogs during the first postoperative period after intraocular surgery.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Aged, 80 and over
  • Animals
  • Anti-Bacterial Agents / therapeutic use
  • Dog Diseases / diagnosis
  • Dog Diseases / microbiology
  • Dogs
  • Endophthalmitis / drug therapy
  • Endophthalmitis / microbiology*
  • Endophthalmitis / veterinary
  • Eye Infections, Bacterial / drug therapy
  • Eye Infections, Bacterial / microbiology*
  • Eye Infections, Bacterial / veterinary
  • Female
  • Humans
  • Lens Implantation, Intraocular
  • Phacoemulsification*
  • Postoperative Complications*
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / microbiology*
  • Staphylococcal Infections / veterinary
  • Staphylococcus / isolation & purification*
  • Vancomycin / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Vancomycin