Dataset Information

Infective Endocarditis Presenting as Endogenous Endophthalmitis Secondary to Streptococcus agalactiae in a Healthy Adult: Case Reports and Literature Review.

ABSTRACT: Endogenous endophthalmitis secondary to group B Streptococcus (GBS) is extremely rare, particularly in healthy adults. However, the visual prognosis is poor. We report the first South Korean case of GBS infective endocarditis presenting as endogenous endophthalmitis and skin and soft tissue infection. Cultures of blood, vitreous humor, and pus from skin aspirates yielded a penicillin-susceptible serotype V strain of Streptococcus agalactiae. After 6 weeks, the patient completely recovered from GBS infective endocarditis. However, despite early antibiotic treatment and early surgical intervention, the patient's right eye developed phthisis bulbi and was a candidate for evisceration.

SUBMITTER: Sim YR

PROVIDER: S-EPMC5754340 | biostudies-literature | 2017 Dec

REPOSITORIES: biostudies-literature

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Publications

Infective Endocarditis Presenting as Endogenous Endophthalmitis Secondary to Streptococcus agalactiae in a Healthy Adult: Case Reports and Literature Review.

Sim Yu Ra YR Lee Ye Jin YJ Park Seung Woon SW Kim Sang Hyun SH Choi Ju Hee JH Choi Jung Yoon JY Kim Min Ja MJ Sohn Jang Wook JW Ahn Jaemoon J Yoon Young Kyung YK

Infection & chemotherapy 20171201 4

Endogenous endophthalmitis secondary to group B Streptococcus (GBS) is extremely rare, particularly in healthy adults. However, the visual prognosis is poor. We report the first South Korean case of GBS infective endocarditis presenting as endogenous endophthalmitis and skin and soft tissue infection. Cultures of blood, vitreous humor, and pus from skin aspirates yielded a penicillin-susceptible serotype V strain of Streptococcus agalactiae. After 6 weeks, the patient completely recovered from G ...[more]

PMID: 29299896

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Project description:BACKGROUND:Group B streptococcus (GBS), a gram-positive coccus that occasionally causes neonatal sepsis or invasive infection in the elderly, has been considered a rare cause of endogenous bacterial endophthalmitis (EBE). However, the number of invasive GBS infections is increasing, particularly in elderly patients with underlying conditions such as diabetes mellitus (DM), cardiovascular disease and cancer. We report 6 cases of EBE caused by GBS and review the literature. METHODS:Retrospective case series and literature review. RESULTS:In the current case series, 6 eyes of 6 patients developed EBE caused by GBS. The average age was 73.5?years. The focus of infection included the urinary tract, cellulitis, arthritis, peritonitis, catheter-associated infection and endocarditis. Four patients had DM. While all 6 strains were sensitive to ?-lactams (penicillins and cephems), 4 strains were resistant to levofloxacin (no data for 1 isolate). Each case was treated with the systemic antibiotic to which the individual strain was sensitive. All cases showed poor visual acuity at presentation (decimal visual acuity: less than 0.03). Vitrectomy with intravitreal antibiotics injection was performed in 4 cases. Visual acuity recovered in 4 cases and did not recover in 2 cases, even after vitrectomy. The literature review of 53 eyes of 41 patients revealed that 60% of eyes finally lost all vision, and death occurred in 2 cases. Initial visual acuity of less than counting fingers was associated with a final outcome of lost vision. Of 41 patients, 13 (32%) had DM as an underlying medical condition. The most common extra-ocular infection focus was endocarditis (37%). CONCLUSIONS:DM is common in patients with EBE caused by GBS. While the 4 cases in the current report had a relatively good visual acuity outcome, despite poor initial visual acuity, the literature review indicated that EBE caused by GBS is generally a severe condition with a poor prognosis. The current study also indicates the importance of considering the possibility of endocarditis on encountering EBE caused by GBS.

Dataset Information

Infective Endocarditis Presenting as Endogenous Endophthalmitis Secondary to Streptococcus agalactiae in a Healthy Adult: Case Reports and Literature Review.

Publications

Infective Endocarditis Presenting as Endogenous Endophthalmitis Secondary to Streptococcus agalactiae in a Healthy Adult: Case Reports and Literature Review.

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