Posters

A rare and unusual case of Streptococcus dysgalactiae endophthalmitis

Poster Details

First Author: J. Wong SINGAPORE

Co Author(s):    R. Agrawal                    

Abstract Details

Purpose:

To present a rare case of Streptococcus Dysgalactiae endogenous endophthalmitis, which had an atypical presentation and resulted in corneal perforation.

Setting:

Case report of an inpatient admitted to a tertiary care hospital in Singapore.

Methods:

We present the atypical presentation, investigations and management of a patient with Streptococcus Dysgalactiae endogenous endophthalmitis. A literature review of the few earlier reported cases will be presented and input from our institution's infectious disease department will be discussed.

Results:

A 68 year old Chinese female was admitted for sepsis from an initially unknown source. She had redness but no pain of her left eye for 1 day. Examination revealed a left eye with visual acuity of counting fingers closely, edematous cornea, 1mm hypopyon and hypotony. There was no view of the posterior pole and B-scan ultrasound revealed clear vitreous. An aqueous tap was performed in view of the clear vitreous, and cultures revealed pansensitive Steptococcus Dysgalactiae. The patient underwent 2 courses of intravitreal injections of antibiotics over 72 hours but suffered a corneal perforated and underwent evisceration. The source of the infection was eventually localized to a heel abscess. Cardiac echocardiography did not reveal any vegetations.

Conclusions:

Septicaemia and endophthalmitis from Steptococcus Dysgalactiae, a Group C Steptococcus, is rare. It can present with severe anterior segment involvement causing hypopyon, corneal edema and hypotony but with a relatively clear vitreous. Anterior chamber paracentesis has been reported to be an acceptable alternative method of obtaining ocular fluid for microbial analysis with good yield. Outcomes of endophthalmitis with this organism usually results in poor outcome.

Financial Disclosure:

NONE