J Korean Ophthalmol Soc.  2012 Jan;53(1):161-167. 10.3341/jkos.2012.53.1.161.

Two Different Cases of Stenotrophomonas Maltophilia Endophthalmitis after Cataract Surgery

• Jung JW
• Kang HK
• Chin HS

• KMID: 2215260
• DOI: http://doi.org/10.3341/jkos.2012.53.1.161

Abstract

PURPOSE
To report 2 different cases of postoperative endophthalmitis caused by Stenotrophomonas maltophilia after cataract surgery.
CASE SUMMARY
A 73-year-old male with diabetes mellitus developed severe pain in the right eye 2 weeks after cataract surgery. The patient was hospitalized with a diagnosis of infectious endophthalmitis, and vitrectomy was performed. Cultures of aqueous humor and vitreous aspirate revealed S. maltophilia. On day 30 after vitrectomy, his visual acuity had improved to 20/20 and there were no recurrences. A 61-year-old female with no significant past medical history was referred for uveitis or delayed onset endophthalmitis 30 days after cataract surgery. An anterior chamber tapping and cultures were performed. S. maltophilia and Aspergillus fumigatus were isolated. The patient received antibiotics and antifungal agents and her visual acuity improved to 20/25.
CONCLUSIONS
S. maltophilia has been considered a life-threatening systemic opportunistic infection; however, the organism has recently been reported as an exogenous pathogen of endophthalmitis following cataract surgery. Herein, 2 different cases of S. maltophilia endophthalmitis after cataract surgery are presented and compared with previous case reports.

Keyword

Aspergillus fumigatus; Coinfection; Postoperative endophthalmitis; Stenotrophomonas maltophilia

MeSH Terms

Aged
Anterior Chamber
Anti-Bacterial Agents
Antifungal Agents
Aqueous Humor
Aspergillus fumigatus
Cataract
Coinfection
Diabetes Mellitus
Endophthalmitis
Eye
Female
Humans
Male
Middle Aged
Recurrence
Stenotrophomonas
Stenotrophomonas maltophilia
Uveitis
Visual Acuity
Vitrectomy
Anti-Bacterial Agents
Antifungal Agents

Figure

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  Figure 1 (A) Initial Fundus photographs are not visible fundus details due to media opacity in the right eye (B) Normal fundus in the left eye.

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  Figure 2 In vitro antibiotic sensitivities of Stenotrophomonas maltophila in Case 1, 2. S = sensitive; R = resistant.

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  Figure 3 Time course of the clinical course and treatment (A) Case 1 (B) Case 2. Cat OP = cataract operation; Inj. = injection; PPV = pars plana vitrectomy; VA = visual acuity; BCVA = best corrected visual acuity; HM = hand motion; F-Amphotericin = fortified amphotericin.

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