Won Jun Yeon, Kim Moosang
Department of Otolaryngology, School of Medicine, Kangwon National University, Chuncheon, Korea.
Clin Ophthalmol. 2013;7:1193-5. doi: 10.2147/OPTH.S46792. Epub 2013 Jun 17.
We report a case of acute postoperative endophthalmitis caused by vancomycin-resistant Staphylococcus hominis, treated at our hospital. An 80-year-old male presented 2 days after uncomplicated phacoemulsification and posterior chamber intraocular lens implantation, with a 24-hour history of progressive visual loss and redness in the operated (right) eye. On examination, best corrected visual acuity was counting fingers. Anterior segment examination revealed conjunctival injection, chemosis, corneal edema, and hypopyon. B-scan ultrasonography showed vitreous opacification, but no retinal detachment. Acute postoperative endophthalmitis was diagnosed. We performed vitrectomy with vancomycin in the irrigating solution, intraocular lens removal, and silicone oil tamponade. Culture of the vitreous grew Staphylococcus hominis. Antibiotic susceptibility testing showed the isolate was sensitive to trimethoprim/sulfamethoxazole and teicoplanin but resistant to ciprofloxacin, moxifloxacin, levofloxacin, cefazolin, and vancomycin. At 3 months, the visual acuity of the silicone oil-treated eye was 20/400.
我们报告了我院收治的一例由耐万古霉素人葡萄球菌引起的急性术后眼内炎病例。一名80岁男性在无并发症的超声乳化白内障吸除术及后房型人工晶状体植入术后2天就诊，术眼（右眼）有24小时渐进性视力丧失及眼红病史。检查时，最佳矫正视力为指数。眼前节检查发现结膜充血、球结膜水肿、角膜水肿及前房积脓。B超显示玻璃体混浊，但无视网膜脱离。诊断为急性术后眼内炎。我们在灌注液中加入万古霉素进行玻璃体切除术、取出人工晶状体并进行硅油填充。玻璃体培养出了人葡萄球菌。药敏试验显示该分离株对复方磺胺甲恶唑和替考拉宁敏感，但对环丙沙星、莫西沙星、左氧氟沙星、头孢唑林和万古霉素耐药。3个月时，硅油治疗眼的视力为20/400。
