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Case Reports
. 2025 Jul 11;19(1):336.
doi: 10.1186/s13256-025-05358-0.

Endophthalmitis caused by Abiotrophia defectiva with initial presentation as retinal vasculitis: a case report

Xiaojie Lu  1 , Bei Liu  1 , Tiemei Yie  1 , Weiwei Wang  2
Affiliations
Case Reports

Endophthalmitis caused by Abiotrophia defectiva with initial presentation as retinal vasculitis: a case report

Xiaojie Lu et al. J Med Case Rep. .

Abstract

Background: Abiotrophia defectiva is primarily known for its association with endocarditis rather than intraocular infections. We reported a case of endophthalmitis caused by Abiotrophia defectiva, presenting as retinal vasculitis in its early stages, a phenomenon rarely documented in literature.

Case presentation: A 50-year-old Han Chinese man presented to the hospital with decreased vision in his left eye. Examination revealed mild vitritis, papilledema, retinal hemorrhages, and peripheral vascular sheathing in the left eye, raising suspicion of retinal vasculitis. In the following hours, his condition worsened dramatically, with the development of hypopyon and severe vitritis obscuring the visualization of the fundus, suggesting endophthalmitis. He subsequently underwent urgent anterior chamber irrigation, vitreous tap, and intravitreal injection. As the symptoms did not improve, a vitrectomy was performed. The culture results identified the presence of Abiotrophia defectiva. Following prompt and effective treatment, the patient's visual acuity showed improvement.

Conclusion: This report delineates a rare case of endophthalmitis caused by Abiotrophia defectiva initially presenting as retinal vasculitis. It emphasizes the need for prompt recognition and treatment of atypical pathogens in postoperative ocular infections to enhance visual outcomes.

Keywords: Abiotrophia defectiva; Case report; Endophthalmitis; Glaucoma; Retinal vasculitis.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Ethical approval was not applicable for this study, as it involved no novel interventions, and all treatments were standard procedures for Abiotrophia defectiva endophthalmitis. The patient provided written, informed consent for the publication of his case and any accompanying images. Consent for publication: 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-in-Chief of this journal. Competing interests: There are no competing interests in this publication.

Figures

Fig. 1
Fig. 1
Images were obtained in the outpatient clinic. a: The anterior segment showed conjunctival hyperemia, a flat filtering bleb, and a clear cornea with mild anterior chamber cells. b: The fudus showed papilledema, retinal hemorrhages, and peripheral vascular sheathing. c: Optical coherence tomography revealed a mass of low reflective lesions in the macular area (red arrow showing low reflective lesions)
Fig. 2
Fig. 2
Images were obtained following the patient’s hospitalization. a: Slit lamp examination revealed a 1.5-mm hypopyon (red arrow showing hypopyon). b: A brightness scan ultrasound confirmed dense vitreous opacities (red arrow showing vitreous opacity)
Fig. 3
Fig. 3
The disease aggravated progressively. Brightness scan ultrasound showed more dense vitreous debris (red arrow showing aggravated vitreous opacity) compared with Fig. 2b
Fig. 4
Fig. 4
Images were obtained following vitrectomy. a: The cornea appeared clear, and no hypopyon was present in the deep anterior chamber. b: Blood flow was restored in the peripheral retinal vessels, accompanied by numerous laser spots in the mid-peripheral retina and occasional dot hemorrhages
See this image and copyright information in PMC

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