Boeke Paul S, Gottlieb Justin L
Department of Ophthalmology, University of Wisconsin, Madison, Wisconsin.
Retin Cases Brief Rep. 2019 Fall;13(4):327-328. doi: 10.1097/ICB.0000000000000588.
Endophthalmitis caused by Stenotrophomonas maltophilia is rare and has been described after cataract surgery and open globe injuries. We report a patient with endophthalmitis caused by this organism after uncomplicated intravitreal aflibercept injection.
A 70-year-old man with a history of anti-vascular endothelial growth factor therapy for diabetic macular edema presented 23 days after aflibercept injection with clinical diagnosis of endophthalmitis. The patient initially had mild pain, conjunctival congestion, and anterior chamber cell; 2 days later, the patient returned with hand motion visual acuity, hypopyon, and dense vitritis.
A tap and inject procedure was performed. The aqueous sample confirmed the presence of S. maltophilia. Antimicrobial testing showed susceptibility to ceftazidime which was used during the initial treatment. After resolution of the vitritis and hypopyon, the visual acuity returned to 20/70 at his 3-month follow-up examination.
Stenotrophomonas maltophilia is a rare infectious agent associated with intravitreal injection and may present 1 month after treatment.
嗜麦芽窄食单胞菌引起的眼内炎较为罕见，已有白内障手术后及开放性眼球损伤后发生该菌感染的报道。我们报告1例在单纯玻璃体内注射阿柏西普后发生嗜麦芽窄食单胞菌性眼内炎的患者。
1例70岁男性患者，有糖尿病性黄斑水肿抗血管内皮生长因子治疗史，在注射阿柏西普23天后出现眼内炎临床诊断表现。患者最初有轻度疼痛、结膜充血和前房细胞；2天后复诊时视力为手动，有前房积脓和浓密的玻璃体炎。
进行了穿刺和注射操作。房水样本证实存在嗜麦芽窄食单胞菌。抗菌药物检测显示对头孢他啶敏感，初始治疗期间使用了该药物。玻璃体炎和前房积脓消退后，患者在3个月随访检查时视力恢复到20/70。
嗜麦芽窄食单胞菌是与玻璃体内注射相关的罕见感染病原体，可能在治疗后1个月出现。
