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 .