Propionibacterium endophthalmitis

ABSTRACT

This is the first report of a Propionibacterium acnes endophthalmitis in Saudi Arabia. The case displayed all characteristic features of this disease entity, including delayed onset following cataract extraction with implantation of an intraoccular lens, delay in diagnosis, intermittent response to corticosteroid therapy alone, typical clinical appearance including a white capsular plaque and vitreitis, delayed growth of the organism on culture, and good recovery of visual function following appropriate treatment. A novel approach to the latter was chosen higher concentrations of the antibiotics [vancomycin, clindamycin, and gentamicin] were injected into the anterior chamber than into the vitreous cavity, the purpose being to achieve maximal concentrations in the region of the intraoccular lens and capsular plaque. With a follow-up of more than a year without recurrence, a cure may be assumed. Regarding the postoperative inflammatory reaction with cystoid macular edema that was observed in the second eye, an infectious etiology can only be ruled out after further follow-up