Postkeratoplasty keratitis caused by Abiotrophia defectiva: An unusual cause of graft infection

Manderwad, Guru Prasad; Murthy, Somasheila I; Motukupally, Swapna Reddy

doi:10.4103/0974-9233.150631

Cited by 5 publications

(4 citation statements)

References 12 publications

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“…Endocarditis was mostly reported caused by Abiotrophia defectiva [6,7]. However, there have been very few reports of Abiotrophia defectiva causing endophthalmitis until submission in the literature, including 5 cases after conventional cataract surgery [4,[8][9][10], 3 cases of keratopath [5,11,12], 2 cases after trabeculectomy [13,14], and 1 case after intravitreal injection of dexamethasone [15]. Different from all the published case reports, for the rapid progress of the endophthalmitis by Abiotrophia defective, the severe vitritis hindering the view of the fundus, we rstly observed retinal vasculitis in the very early stage of this disease.…”

Section: Discussionmentioning

confidence: 99%

A case of Abiotrophia defectiva endophthalmitis with retinal vasculitis

Lu,

Wang

2024

Preprint

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Introduction Endophthalmitis is a severe, vision-threatening intraocular infection that may follow various ophthalmic surgeries, with varying microbial etiologies. Abiotrophia defectiva, a less commonly implicated pathogen, is better recognized for its association with endocarditis rather than intraocular infections. Case presentation A 50-year-old man was diagnosed with endophthalmitis after trabeculectomy for open-angle glaucoma. In the outpatient clinic, he had visual acuity of 20/160, conjunctival congestion, mild anterior chamber inflammation, and preretinal bleeding. In the hours that followed, the condition worsened dramatically. He underwent urgent anterior chamber irrigation, vitreous tap, and intravitreal injection. As the symptoms did not improve, a vitrectomy was performed. The results of postoperative culture were positive for Abiotrophia defectiva. After timely and effective treatment, the patient's visual acuity increased to 20/125. At a one-year follow-up, the patient's visual acuity improved to 20/32. Conclusion This report delineates a rare case of endophthalmitis caused by Abiotrophia defectiva following trabeculectomy, emphasizing the need for prompt recognition and treatment of atypical pathogens in postoperative ocular infections to enhance visual outcomes.

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Section: Discussionmentioning

confidence: 99%

A case of Abiotrophia defectiva endophthalmitis with retinal vasculitis

Lu,

Wang

2024

Preprint

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“…A defectiva, although sporadically reported in keratitis, have not previously been reported in patients who have had LASIK. [22][23][24] K kristinae is facultative anaerobe, opportunistic gram-positive cocci from the family Micrococcaceae and a commensal bacterium of skin and mucous membranes. 25 A defectiva 26 There are several reports of uncommon microorganisms post-LASIK.…”

Section: Discussionmentioning

confidence: 99%

Late onset of microbial keratitis after laser in situ keratomileusis surgery: case series

Garcerant

Cabrera‐Aguas

Khoo³

et al. 2021

J Cataract Refract Surg

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“…Part of the normal human microbiota, this organism inhabits the oral, genitourinary and intestinal mucosae [ 4 ]. It is not usually found in the conjunctival sac or ocular adnexae [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…In ophthalmology, the literature presents cases of crystalline keratopathy [ 12 ], infiltrative keratitis in contact lens wearers [ 13 ] and post-keratoplasty keratitis with hallmark features of well-circumscribed infiltrates and intense inflammatory reactions [ 5, 14 ]. Post-operative endophthalmitis following cataract surgery has been described, twice in routine cases [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Abiotrophia defectiva endophthalmitis following routine cataract surgery: the first reported case in the United Kingdom

Chihaia

Richardson-May

Alsaffar

et al. 2020

Access Microbiology

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Introduction. Abiotrophia defectiva is a fastidious organism that has been implicated in severe infections such as endocarditis in immunocompetent patients. Modern tools are available to aid identification, but the main challenge remains clinical suspicion of A. defectiva . Case presentation. An otherwise fit and well 65-year-old female presented with reduced vision, red eye and discomfort 2 days following routine left cataract surgery. She had visual acuity of light perception only, significant anterior chamber inflammation (including hypopyon) and limited fundal view. She was diagnosed with post-operative endophthalmitis and 0.1 ml of ceftazidime (2 mg/0.1 ml) and 0.1 ml vancomycin (2 mg/0.1 ml) were injected intravitreally after vitreous aspiration. Subconjunctival cefuroxime was also injected. A repeat injection was performed on day three of admission. Gram staining revealed Gram-positive long-chain cocci, which were identified as A. defectiva . The patient was discharged on oral ciprofloxacin 500 mg twice a day with oral prednisolone 60 mg once a day; this was tapered and stopped at 8 weeks post-discharge. The left eye received dexamethasone 0.1 % 6 times a day (again, tapered over 8 weeks), moxifloxacin 5 % 6 times a day and atropine 1 % twice a day. Vision improved to 6/12 unaided (6/9.5 with pinhole) at 9 weeks post-operatively, with a clear fundal view. Conclusion. We present a case of A. defectiva endophthalmitis following routine cataract surgery. To our knowledge, this is the first reported case in the UK and the fourth globally, which with prompt treatment ended with a good visual outcome.

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Postkeratoplasty keratitis caused by Abiotrophia defectiva: An unusual cause of graft infection

Cited by 5 publications

References 12 publications

A case of Abiotrophia defectiva endophthalmitis with retinal vasculitis

A case of Abiotrophia defectiva endophthalmitis with retinal vasculitis

Late onset of microbial keratitis after laser in situ keratomileusis surgery: case series

Abiotrophia defectiva endophthalmitis following routine cataract surgery: the first reported case in the United Kingdom

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