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ENDOGENOUS SERRATIA MARCESCENS ENDOPHTHALMITIS

Shah, Sonya B. MD; Bansal, Alok S. MD; Rabinowitz, Michael P. MD; Park, Carl MD; Bedrossian, Edward H. Jr MD; Eagle, Ralph C. MD

RETINAL Cases & Brief Reports: Winter 2014 - Volume 8 - Issue 1 - p 7–9
doi: 10.1097/ICB.0b013e318298bf6a
Case Report

Purpose: The purpose of this study was to describe a rare case of endogenous endophthalmitis associated with dental disease secondary to Serratia marcescens in an HIV-negative individual.

Methods: Retrospective case report.

Results: A 50-year-old white man with a history of intravenous drug use presented with pain and decreased vision in his right eye. Slit-lamp examination showed a hazy cornea, hypopyon with fibrin in the anterior chamber, and elevated intraocular pressure. B-scan ultrasound showed vitritis and choroidal thickening. Computed tomography showed gingival inflammation and lucencies of several teeth. Blood and urine cultures were negative, and HIV testing was negative. Echocardiography was negative for vegetations. Intravitreal culture revealed S. marcescens. Despite intravitreal and systemic antibiotics, the patient’s clinical situation rapidly deteriorated, and the eye was eviscerated. The patient underwent dental extraction and was subsequently discharged in stable condition.

Conclusion: The first case of endogenous endophthalmitis secondary to S. marcescens in an otherwise healthy, HIV-negative, intravenous drug user in association with severe dental disease is reported. Serratia may be found in oral biofilm, and this mechanism should be considered in cases where other etiologies have been ruled out.

A 50-year-old man with a history of dental disease and intravenous drug use presented with fulminant endogenous endophalmitis in his right eye. Vitreous cultures grew Serratia marcescens, whereas blood and urine cultures were negative, and HIV testing was negative. Despite intravitreal and systemic antibiotics, the eye had poor visual and anatomic outcomes and was eviscerated.

Wills Eye Institute, Philadelphia, Pennsylvania.

Reprint requests: Alok S. Bansal, MD, 2485 Hospital Drive, Suite 200, Mountain View, CA 94301; e-mail: alok.s.bansal@gmail.com

None of the authors have any financial/conflicting interests to disclose.

Supported by the J. Arch McNamara Research Fund.

© 2014 by Ophthalmic Communications Society, Inc.