Chronic postoperative endophthalmitis caused by Cutibacterium (formerly Propionibacterium) acnes: A case diagnosed by polymerase chain reaction and treated by vitrectomy with partial capsulectomy
We present the diagnosis and treatment strategy in a 76-year-old woman with chronic postoperative endophthalmitis caused by Cutibacterium acnes (C. acnes). She presented with persistent blurred vision of her right eye for 9 months after cataract surgery at a local clinic and was referred to our hosp...
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| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2025-04-01
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| Series: | Taiwan Journal of Ophthalmology |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/tjo.TJO-D-23-00035 |
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| Summary: | We present the diagnosis and treatment strategy in a 76-year-old woman with chronic postoperative endophthalmitis caused by Cutibacterium acnes (C. acnes). She presented with persistent blurred vision of her right eye for 9 months after cataract surgery at a local clinic and was referred to our hospital. On examination, the right eye’s best-corrected visual acuity (BCVA) was 0.03, and the intraocular pressure (IOP) was 35 mmHg. Slit-lamp examination revealed congested conjunctiva, cells 1+ and flares 1+ in the anterior chamber, white plaque on the intraocular lens and capsule, and vitreous opacity. The B-scan also revealed vitreous opacity. Initial treatment of vitrectomy, partial capsulectomy (PC) with intraocular antibiotics (IOABs) (vancomycin and ceftazidime) injection was done immediately after the IOP was controlled to a normal range (18 mmHg). The IOP on postoperative day 1 was 15.3 mmHg. Although vitreous cultures yielded no bacterial growth, the polymerase chain reaction (PCR) confirmed the diagnosis of C. acnes infection. PCR has several advantages over traditional culture methods, providing high sensitivity, specificity, and speed. Postoperative examination revealed no cells in the anterior chamber, less plaque, and a clear vitreous cavity. The BCVA improved to 0.7 at 6 months after the surgery. No guidelines or standard treatments exist due to the broad range of the severity of postoperative chronic endophthalmitis. We suggest a combination of pars plana vitrectomy, PC, and IOAB injection as the initial treatment for chronic postoperative C. acnes endophthalmitis. |
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| ISSN: | 2211-5056 2211-5072 |