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Case Reports
. 2017 Oct 11;17(1):190.
doi: 10.1186/s12886-017-0573-5.

First identification of Gordonia sputi in a post-traumatic endophthalmitis patient - a case report and literatures review

Wei Fang  1 , Jiuke Li  1 , Hu-Shan Cui  1 , Xiaohong Jin  1 , Jing Zhai  1 , Yuanmin Dai  1 , Yumin Li  2
Affiliations
Case Reports

First identification of Gordonia sputi in a post-traumatic endophthalmitis patient - a case report and literatures review

Wei Fang et al. BMC Ophthalmol. .

Abstract

Background: We present a case of post-traumatic endophthalmitis with relatively good prognosis caused by Gordonia sputi, which, to our knowledge is the first case in the literature.

Case presentation: A 24 year old man, who underwent an intraocular foreign body extraction half a month before presentation in the left eye, was referred to us complaining of blurred vision and slight pain for 5 days. His first presentation showed moderate intracameral and intravitreous purulent inflammation with a best corrected vision of counting fingers. After gram staining of the intravitreous samples revealed a gram-positive bacilli infection, a combination of amikacin and vancomycin was initially injected intravitreously. The left eye kept stable for three days but deteriorated on the 4th day. On the 5th day after presentation conventional culture characterized the bacterium as an Actinomyces sp. while 16S ribosomal RNA gene sequencing confirmed it as Gordonia sputi. Thereby a complete pars plana vitrectomy combined with lensectomy and silicone oil tamponade was performed. During the surgery an intraocular irrigation with penicillin G was adopted, followed by administration of intravenous penicillin G twice one day for a week. A relatively normal fundus with slight intracameral inflammation was observed a week after the operation, and the best corrected vision recovered to 0.15. One year later his vision remained 0.1.

Conclusion: Gordonia sputi should be taken into consideration in patients with post-traumatic endophthalmitis especially due to foreign body penetration. Compared to conventional laboratories, molecular methods are recommended for an accurate diagnosis. A comprehensive strategy of antimicrobial agents and vitrectomy may render a satisfactory result.

Keywords: Actinomyces; Case report; Endophthalmitis; Gordonia sputi; Traumatic.

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Conflict of interest statement

Authors’ information

Prof. LYM. is the deputy director of Ophthalmology Department of Sir Run Run Shaw Hospital, also a well-known specialist majoring vitreoretinopathy and cataract in China. F.W., LJK., CHS., ZJ. and JXH. are fellows in this department. DYM. is a senior resident. All members of this group have experience in clinical treatment, animal models, cells culture, and genetic maneuvers of vitreoretinopathy.

Consent for publication

A written informed consent was obtained from the patient for publication of this Case report and any accompanying images. A copy of the written consent is available for review by the Editor of this journal.

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
Pre-operative evaluation of the infected eye. a slitlamp examination at first presentation revealed moderate congestion in the left eye, with a transparent cornea, anterior cells4+, about two millimeters high hypopyon, a transparent lens. b ultrasonic B scan showed severe vitreous opacity without any posterior vitreous detachment. c after keeping stable for three days with vitreous injection of antibiotics, his left eye deteriorated obviously on the 4th day, with a vision of hand movement and an unobservable fundus
Fig. 2
Fig. 2
Post-operative evaluation of the infected eye. a-b one week after operation, a relatively normal fundus with slight intracameral inflammation was observed, with a best corrected vision of 0.15. c one year later the retina keep attached with slight fibrous proliferation beside optic head and the vision remained 0.1
See this image and copyright information in PMC

References

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