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Recurrent Enterococcus faecalis endophthalmitis after phacoemulsification.

Stephen C B Teoh·Jong-Jian Lee·Caroline K L Chee·Kah-Guan Au Eong
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Abstract

We present the first reported case of late recurrence of postoperative Enterococcus faecalis endophthalmitis after cataract surgery in a 45-year-old diabetic man. Culture-positive E faecalis endophthalmitis was diagnosed 2 days after uneventful phacoemulsification. Early vitrectomy with intravitreal and subconjunctival vancomycin and amikacin and topical vancomycin resulted in apparently complete clinical resolution after 4 months and a best corrected visual acuity of 20/25. Recurrent endophthalmitis with hypopyon occurred 7 months postoperatively and resolved with intravitreal vancomycin and topical prednisolone acetate 1%. However, the patient had a similar relapse at 9 months that resulted in deterioration of visual acuity to no light perception despite a repeat vitrectomy, intraocular lens explantation, capsular bag removal, and intravitreal antibiotics. The late recurrences could have been the result of persistent sequestration of the organism in the capsular bag.

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AmikacinDrug Therapy, CombinationEndophthalmitisEnterococcus faecalisEye Infections, BacterialGram-Positive Bacterial InfectionsHumansMaleMiddle AgedPhacoemulsificationPostoperative ComplicationsRecurrenceVancomycinVitrectomyCase ReportsJournal ArticleReview

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Stephen C B Teoh, Jong-Jian Lee, Caroline K L Chee, Kah-Guan Au Eong. 2005. Recurrent Enterococcus faecalis endophthalmitis after phacoemulsification.. https://doi.org/10.1016/j.jcrs.2004.06.047

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