Bilateral sequential Propionibacterium acnes exogenous endophthalmitis

Abstract

A 68-year-old man underwent uncomplicated sequential cataract extractions performed more than a year apart. He presented 6 months after the second surgery with persistent intraocular inflammation in both eyes. Cultures from both eyes grew Propionibacterium acnes and he responded well to treatment. Suspicion for delayed-onset post-operative endophthalmitis must remain high in uveitis cases that fail to resolve with anti-inflammatory treatments. The authors believe this is the first reported case of bilateral sequential P. acnes exogenous endophthalmitis.

Comparison of the Vitreous Fluid Bacterial Microbiomes between Individuals with Post Fever Retinitis and Healthy Controls

“…In the VC group all the genera except Propionibacterium, an opportunistic pathogen with proinflammatory activity [37,38], exhibited more than 13 negative interactions out of 15 possible interactions with other genera. An earlier study had also indicated that Propionibacterium was associated with intraocular inflammatory diseases like Uveitis and Endophthalmitis [39]. Therefore, increase in the abundance of Propionibacterium in VC group was not anticipated.…”

Propionibacterium acnes–associated Delayed-onset Pseudophakic Endophthalmitis

“…35 Pathologic specimens from case reports of delayed-onset pseudophakic endophthalmitis demonstrate the ability of P. acnes to form biofilms in the IOL-capsular bag complex. [36][37][38] Saika et al, 39 for example, reported a focus of gram-positive rods inside the capsular bag on light microscopy with Gram staining. Immunohistochemistry demonstrated extracellular matrix formation in the capsular bag and around the IOL with particularly marked immunoreactivity at the focus of the bacterial infection.…”

“…P. acnes can form biofilms on a variety of different biomaterials and P. acnes isolated from biofilms demonstrate increased antibiotic resistance 35. Pathologic specimens from case reports of delayed-onset pseudophakic endophthalmitis demonstrate the ability of P. acnes to form biofilms in the IOL-capsular bag complex 36–38. Saika et al,39 for example, reported a focus of gram-positive rods inside the capsular bag on light microscopy with Gram staining.…”

Diagnóstico etiológico das endoftalmites e análise direta do humor vítreo em frasco de hemocultura por espectrometria de massas MALDI-TOF

“…com o uso do frasco de hemocultura infantil reforça a possibilidade de se usar o frasco como único meio para inoculação nos casos suspeitos de microrganismos aeróbios. de microrganismos podem dificultar a identificação dos agentes anaeróbios (128) . O PCR, metagenômica e coleta do humor vítreo por meio de vitrectomia podem melhorar a detecção dos casos em que existe alta suspeita apesar de culturas negativas (6) .…”