Crystalline lens dislocation secondary to bacterial endogenous endophthalmitis.
Sangave A, Komati R, Weinmann A, Samuel L, and Desai U. Crystalline lens dislocation secondary to bacterial endogenous endophthalmitis. Am J Ophthalmol Case Rep 2017; 7:149-152.
Am J Ophthalmol Case Rep
Purpose: To present an unusual case of endogenous endophthalmitis secondary to Group A
Observations: An immunocompetent 51-year-old man presented to the emergency room (ER) with upper respiratory infection (URI) symptoms and painful right eye. He was diagnosed with URI and viral conjunctivitis and discharged on oral azithromycin and polytrim eyedrops. He returned to the ER 30 h later with sepsis and findings consistent with endophthalmitis, including light perception only vision. Ophthalmology was consulted at this time and an emergent vitreous tap and injection was performed. Both blood and vitreous cultures grew an atypical non-hemolytic variant of GAS (
Conclusions and importance: Endophthalmitis secondary to GAS has been sparsely reported in the literature, and this case highlights a unique clinical presentation. We suspect that this atypical non-hemolytic strain may have evaded detection on initial pharyngeal cultures. Additionally, we hypothesize that GAS-mediated protease release resulted in breakdown of the zonular fibers and subsequent lens dislocation. Ophthalmologists should be aware of GAS and its devastating intraocular manifestations.