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Postkeratoplasty Endophthalmitis by Alcaligenes faecalis: A Case Report

Khokhar, D. Sudarshan M.D.; Sethi, Harinder Singh M.D.; Kumar, Harsh M.D.; Sudan, Rajeev M.D.; Sharma, Namrata M.D.; Nayak, Niranjan M.D.

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Purpose. To describe a postkeratoplasty endophthalmitis owing to Alcaligenes faecalis that resolved with medical management.

Methods. Case report and review of literature.

Results. To best of our knowledge, postkeratoplasty endophthalmitis caused by A. faecalis has not been reported in literature. The source of infection was found to be the donor tissue. The organism isolated was resistant to gentamicin, which was the only antibiotic present in the storage medium (McCarey and Kaufman medium). The patient was treated aggressively with topical, systemic and intravitreal antibiotics. The endophthalmitis resolved completely within two weeks.

Conclusion. A. faecalis is a gram negative, non-spore forming rod that can cause endophthalmitis if donor tissue is contaminated with the organism. Clinical suspicion, review of bacterial culture and sensitivity report from donor tissue, anterior chamber and vitreous taps, along with early therapy with appropriate antibiotics can lead to resolution of infection.

From the Cornea (S.K., H.S.S., K.K., R.S., N.S.) and Microbiology (N.N.) Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.

Submitted April 25, 2001.

Revision received October 12, 2001.

Accepted October 18, 2001.

The authors have no financial interest.

Address correspondence and reprint requests to Sudarshan Khokhar, M.D., Associate Professor, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India. E-mail: skhokhar38@hotmail.com

© 2002 Lippincott Williams & Wilkins, Inc.