Actinobacillus actinomycetemcomitans endogenous endophthalmitis: report of two cases and review of the literature

Abstract

Endogenous endophthalmitis due to Actinobacillus actinomycetemcomitans is an unusual disease with serious sequelae. Of the 4 cases published in the literature only 1 recovered useful vision after treatment. This study reports on 1 additional patient and expands on the previously described brief ophthalmology case report of another patient with marked visual impairment at presentation and good visual recovery after treatment. Of the 5 patients described, 4 had pre-existing heart abnormalities, 3 had permanent pacemakers and 2 had periodontal disease. Definite endocarditis by Duke criteria was present in 3 patients. Endocarditis should be ruled out in every patient with A. actinomycetemcomitans endophthalmitis, even in the absence of systemic complaints and prior penicillin prophylaxis. Eye specimen cultures should be incubated for 10 d. A thorough dental examination should be done in each patient and any periodontal disease should be promptly treated.