Pigmented hypopyon in association with Listeria monocytogenes endopthalmitis: An interesting case report following refractive surgery procedure with literature review

Abstract

Purpose:Listeria monocytogenes is an aerobic, motile, gram positive bacillus recognized as an intercellular pathogen in human where it most frequently affects neonates, pregnant women, elderly patients, and immunosuppressed individuals as well as healthy persons. Ocular listeriosis is rare, most frequently in the form of conjunctivitis, but has been also shown to cause rarely endophthalmitis with pigmented hypopyon and elevated intraocular pressure such as in our case.Materials and Methods:We are reporting one immunocompetent patient presenting with dark hypopyon following laser refractive procedure. His clinical findings, investigations, and further management are all described with relevant literature review of similar cases.Results:Diagnosis of ocular listeriosis was confirmed by positive culture of anterior chamber (AC) aspirate with identification of the above organism. His visual outcome was satisfactory with good preserved vision.Conclusion:We believe that his ocular infection was exogenous and that ophthalmologists should be aware of the causative organisms of colored hypopyon to avoid delayed diagnosis.

Listeria Monocytogenes Endophthalmitis after Intermediate Uveitis and ppV for Retinal Detachment

“…There are relatively few reported cases of Listeria monocytogenes endophthalmitis, most of them are presumed to be endogenous by hematogenous dissemination, although a source of infection often cannot be found. Exogenous infection in a young immunocompetent patient has also been described [6]. Patients with systemic infections may develop endophthalmitis because of the possibility of subtherapeutic levels of antibiotics within the eye [9].…”

Listeria monocytogenes endophthalmitis – case report and review of risk factors and treatment outcomes

“…Five cases (19 %) occurred in patients with chronic diseases such as neurodermitis, sacroiliitis, diabetes mellitus (present case), arterial hypertension, hypothyroidism, or previous history of cancer or surgery (coronary artery bypass graft) [ 16 , 21 , 24 , 26 , 30 ] (Table 2 ) . Six cases (22 %) occurred in elderly patients (age 62–76) in good physical health [ 9 , 10 , 12 , 13 , 18 , 23 , 33 ], and the remaining four cases (15 %) affected young (age 27–47), healthy individuals [ 20 , 28 , 31 , 32 ]. More specifically, the recently published cases describe two young patients (age 27, 28), both having a history of refractive ocular surgery [ 31 , 32 ].…”

“…Six cases (22 %) occurred in elderly patients (age 62–76) in good physical health [ 9 , 10 , 12 , 13 , 18 , 23 , 33 ], and the remaining four cases (15 %) affected young (age 27–47), healthy individuals [ 20 , 28 , 31 , 32 ]. More specifically, the recently published cases describe two young patients (age 27, 28), both having a history of refractive ocular surgery [ 31 , 32 ]. In both of these cases, an exogenous infection is more apparent, whereas in all other reported cases an exogenous source of infection could not be identified.…”

Listeria Infections of the Eye

“…In general, local infection remains confined to the anterior portions of the eye (39). In one report, however, eye infection with Listeria started with conjunctivitis and resulted finally in endophthalmitis (40).…”