J Korean Ophthalmol Soc > Volume 60(7); 2019 > Article
Journal of the Korean Ophthalmological Society 2019;60(7):701-705.
DOI: https://doi.org/10.3341/jkos.2019.60.7.701    Published online July 15, 2019.
Chronic Recurrent Methicillin Resistant Staphylococcus Hemolyticus Endophthalmitis after Cataract Surgery.
Dae Sung Kim, Min Jee Lee, Min Cheol Seong, Min Ho Kang, Hee Yoon Cho, Yong Un Shin
Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea. syu2000@hanmail.net
백내장수술 후 발생한 만성 재발 메티실린 내성 용혈포도상구균 안내염
김대성⋅이민지⋅성민철⋅강민호⋅조희윤⋅신용운
한양대학교 의과대학 안과학교실
Correspondence:  Yong Un Shin,
Email: syu2000@hanmail.net
Received: 13 September 2018   • Revised: 25 November 2018   • Accepted: 19 June 2019
Abstract
PURPOSE
To report a case of recurrent endophthalmitis due to methicillin resistant Staphylococcus hemolyticus after phacoemulsification and posterior chamber intraocular lens (IOL) implantation. CASE SUMMARY: A 76-year-old female visited our outpatient clinic with decreased vision 40 days after uncomplicated cataract surgery in her right eye. At the visit, anterior chamber inflammation and cloudy fluid between the posterior capsule and IOL were observed. Uveitis due to residual cortex of lens or capsular block syndrome was suspected, so YAG laser capsulotomy and subconjunctival injection of dexamethasone were performed. Two days later, hypopyon and vitreous opacity were seen. The patient underwent an emergency vitrectomy and intravitreal antibiotic injection with suspicion of bacterial endophthalmitis. The culture was negative. Twenty days after the vitrectomy, anterior chamber inflammation and vitreous opacity developed. The recurrence of endophthalmitis was suspected due to infection by bacteria in the surrounding tissue of the IOL, so the patient underwent an IOL and lens capsule removal with intravitreal antibiotic injection. At this time, the culture revealed methicillin resistant staphylococcus hemolyticus. Systemic and topical vancomycin was then administered, resulting in decreased inflammation. Twenty days after the IOL removal, decreased vision, anterior chamber inflammation, and vitreous opacity developed. Endophthalmitis was decreased by intravitreal antibiotic injection and topical antibiotic treatment. CONCLUSIONS: Methicillin resistant staphylococcus hemolyticus should be considered in the differential diagnosis of chronic recurrent endophthalmitis after cataract surgery.
Key Words: Endophthalmitis;Methicillin resistant Staphylococcus;Recurrent


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