Friedman Daniel Zp, Chesdachai Supavit, Shweta Fnu, Mahmood Maryam
Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, United States.
William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, Minnesota, United States.
J Assoc Med Microbiol Infect Dis Can. 2021 Dec 3;6(4):313-318. doi: 10.3138/jammi-2021-0016. eCollection 2021 Dec.
Endogenous endophthalmitis caused by , an organism with intrinsic resistance to vancomycin, has rarely been reported. We present a case of persistent bacteremia in a female recipient of hematopoietic stem cell transplant (HSCT) complicated by endophthalmitis and meningoventriculitis, resulting in a fatal outcome despite treatment with intravenous ampicillin and daptomycin. Treatment of endophthalmitis often presents a challenge due to the lack of options for antimicrobials with reliable ocular penetration. Therapeutic decisions can become particularly complex with the involvement of drug-resistant pathogens and host characteristics that limit the choice of antimicrobials due to drug toxicity. This case illustrates a rare manifestation of an opportunistic pathogen.
由对万古霉素具有内在耐药性的一种微生物引起的内源性眼内炎鲜有报道。我们报告了一例造血干细胞移植（HSCT）女性受者发生持续性菌血症，并发眼内炎和脑膜脑室炎，尽管接受了静脉注射氨苄西林和达托霉素治疗，仍导致了致命结局。由于缺乏具有可靠眼内渗透性的抗菌药物选择，眼内炎的治疗常常面临挑战。当涉及耐药病原体以及因药物毒性而限制抗菌药物选择的宿主特征时，治疗决策可能会变得尤为复杂。本病例说明了一种机会性病原体的罕见表现。
