A case of postoperative Sphingomonas paucimobilis endophthalmitis after cataract extraction

Abstract

Purpose: To report a case of an acute onset of delayed postoperative endophthalmitis that was caused by Sphingomonas paucimobilis.

Methods: This case demonstrates an acute onset of delayed postoperative endophthalmitis at 3 months after uneventful cataract extraction and posterior chamber intraocular lens implantation. We performed vitrectomy, intraocular lens and capsular bag removal, and intravitreal antibiotics injection. On the smear stains from the aspirated vitreous humor, gram-negative bacilli were detected and S. paucimobilis was found in culture.

Results: At three months after vitrectomy, the best corrected visual acuity was 20/300. Fundus examination showed mild pale color of optic disc and macular degeneration.

Conclusions: Vitrectomy with intravitreal ceftazidime injection had contributed to the favorable result in case of an acute onset of delayed postoperatire endophthalmitis caused by S. paucimobilis.

Fig. 1

(A) Clinical slit-lamp photograph of right eye showing severe conjunctival injection, subconjunctival hemorrhage, corneal stromal edema, and hypopyon in the anterior chamber (on admission day). (B) Fundus photograph shows a mild pale color of optic disc & macular degeneration like pigmentary changes at fovea.

Fig. 2

Culture of aspirated vitreous fluid shows growth of phingomonas paucimobilis (Culture media: blood agar).

Fig. 3

The photograph of Sphingomonas paucimobilis in cultured vitreous fluid shows gram-negative bacilli (gram stain; original magnification, ×400).