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由缺陷乏养菌引起的眼内炎,最初表现为视网膜血管炎:一例病例报告。

Endophthalmitis caused by Abiotrophia defectiva with initial presentation as retinal vasculitis: a case report.

作者信息

Lu Xiaojie, Liu Bei, Yie Tiemei, Wang Weiwei

机构信息

Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Affiliated People's Hospital, Northwest University, Xi'an, 710004, Shaanxi, China.

出版信息

J Med Case Rep. 2025 Jul 11;19(1):336. doi: 10.1186/s13256-025-05358-0.

Abstract

BACKGROUND

Abiotrophia defectiva is primarily known for its association with endocarditis rather than intraocular infections. We reported a case of endophthalmitis caused by Abiotrophia defectiva, presenting as retinal vasculitis in its early stages, a phenomenon rarely documented in literature.

CASE PRESENTATION

A 50-year-old Han Chinese man presented to the hospital with decreased vision in his left eye. Examination revealed mild vitritis, papilledema, retinal hemorrhages, and peripheral vascular sheathing in the left eye, raising suspicion of retinal vasculitis. In the following hours, his condition worsened dramatically, with the development of hypopyon and severe vitritis obscuring the visualization of the fundus, suggesting endophthalmitis. He subsequently underwent urgent anterior chamber irrigation, vitreous tap, and intravitreal injection. As the symptoms did not improve, a vitrectomy was performed. The culture results identified the presence of Abiotrophia defectiva. Following prompt and effective treatment, the patient's visual acuity showed improvement.

CONCLUSION

This report delineates a rare case of endophthalmitis caused by Abiotrophia defectiva initially presenting as retinal vasculitis. It emphasizes the need for prompt recognition and treatment of atypical pathogens in postoperative ocular infections to enhance visual outcomes.

摘要

背景

缺陷乏养菌主要因与心内膜炎相关而非眼内感染而为人所知。我们报告了一例由缺陷乏养菌引起的眼内炎病例,其早期表现为视网膜血管炎,这一现象在文献中鲜有记载。

病例介绍

一名50岁的中国汉族男性因左眼视力下降入院。检查发现左眼有轻度玻璃体炎、视乳头水肿、视网膜出血和周边血管鞘,怀疑为视网膜血管炎。在接下来的几个小时里,他的病情急剧恶化,出现前房积脓和严重的玻璃体炎,眼底无法看清,提示眼内炎。随后他接受了紧急前房冲洗、玻璃体穿刺和玻璃体内注射。由于症状没有改善,进行了玻璃体切除术。培养结果确定存在缺陷乏养菌。经过及时有效的治疗,患者视力有所改善。

结论

本报告描述了一例罕见的由缺陷乏养菌引起的眼内炎病例,最初表现为视网膜血管炎。它强调了在术后眼部感染中及时识别和治疗非典型病原体以提高视觉效果的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f173/12247376/5db4649d810f/13256_2025_5358_Fig1_HTML.jpg

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