| Two Cases of Unusual Presentation of Postoperative Endophthalmitis Caused by Streptococcus dysgalactiae Subspecies Equisimilis. |
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Woong Sun Yoo, Hyun Ji Kang, Ji Sung Jeong, Min Ho Shin, Inyoung Chung |
1Department of Ophthalmology, College of Medicine, Gyeongsang National University, Jinju, Korea. inyoung@gnu.ac.kr
2Health Science Institute, Gyeongsang National University, Jinju, Korea. |
| 백내장수술 후 발생한 비전형적 임상양상의 스트렙토코커스 디스갈락티아 안내염 2예 |
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유웅선1⋅강현지1⋅정지성1⋅신민호1⋅정인영1,2 |
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경상대학교 의과대학 안과학교실1, 경상대학교 건강과학연구원2 |
Correspondence:
Inyoung Chung,
Email: inyoung@gnu.ac.kr
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Received: 4 October 2018 • Revised: 26 October 2018 • Accepted: 19 February 2019 |
| Abstract |
PURPOSE
To report two cases of postoperative endophthalmitis caused by Streptococcus dysgalactiae subspecies equisimilis (SDSE), which appeared as hyperacute presentation and panophthalmitis. CASE SUMMARY: A 68-year-old male was treated with cataract surgery and was evaluated the next day (less than 24 hours after surgery) because of acute loss of vision. There was severe inflammation and the visual acuity was light perception. The patient underwent pars plana vitrectomy (PPV) with intravitreal antibiotic injection. The vitreous culture revealed SDSE. After PPV, regression of inflammation was observed, although the corneal edema had progressed. The cornea evolved to decompensate due to bullous keratopathy and visual acuity of the eye decreased to no light perception after 3 months. A 87-year-old male who underwent phacoemulsification and intraocular lens implantation 2 days previously was hospitalized due to severe ocular pain and visual loss. There was severe inflammation, and the visual acuity was no light perception. The patient received only intravitreal injections of antibiotics due to severe corneal necrosis. The aqueous humor revealed SDSE. Four days after intravitreal injection, erythema and swelling of the eyelid of the affected eye was observed, and diagnosed as panophthalmitis. After treatment with intravenous antibiotics, cellulitis of the eyelid was resolved. The eye progressed as phthisis after 3 months without recurrence. CONCLUSIONS: Postoperative SDSE endophthalmitis showed aggressive and hyperacute presentation, resulting in blindness despite prompt treatment. SDSE is an emerging organism and should be considered a potential cause of postoperative endophthalmitis. |
| Key Words:
Endophthalmitis;Eye infections;Panophthalmitis;Streptococcus;Streptococcus dysgalactiae subspecies equisimilis |
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