Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 26, 2023; 11(27): 6592-6596
Published online Sep 26, 2023. doi: 10.12998/wjcc.v11.i27.6592
Delayed-onset micrococcus luteus-induced postoperative endophthalmitis several months after cataract surgery: A case report
Ki-Yup Nam, Hong-Won Lee
Ki-Yup Nam, Hong-Won Lee, Department of Ophthalmology, Chungnam National University, College of Medicine, Daejeon 35015, South Korea
Ki-Yup Nam, Hong-Won Lee, Department of Ophthalmology, Chungnam National University Hospital, Daejeon 35015, South Korea
Author contributions: Nam KY designed the study; Lee HW and Nam KY contributed to the analysis and interpretation of data; Lee HW, and Nam KY contributed to the collection of data; Lee HW and Nam KY drafted the manuscript; Lee HW and Nam KY contributed to the critical review of the article; and all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ki-Yup Nam, MD, PhD, Associate Professor, Department of Ophthalmology, Chungnam National University, College of Medicine, 266 Munhwa-ro, Jung-gu, Daejeon 35015, South Korea. oksnam1231@daum.net
Received: June 26, 2023
Peer-review started: June 26, 2023
First decision: August 10, 2023
Revised: August 22, 2023
Accepted: August 29, 2023
Article in press: August 29, 2023
Published online: September 26, 2023
Processing time: 86 Days and 13.9 Hours
Abstract
BACKGROUND

Micrococcus luteus (M. luteus)-induced endophthalmitis is very rare and and may present as either acute or chronic postoperative endophthalmitis. The aim of this study was to report a case of delayed-onset M. luteus-induced endophthalmitis that occurred several months after cataract surgery.

CASE SUMMARY

A 78-year-old man presented with decreased vision, pain and redness in the right eye that had begun 3 days prior. He had undergone cataract surgery 4 mo prior. Visual acuity was counting fingers; slit-lamp examination revealed conjunctival injection, posterior corneal precipitates, anterior chamber inflammation (cell 4+), and hypopyon. Fundus examination revealed moderate vitreous haze. Urgent vitrectomy was performed for suspected infectious endophthalmitis, followed by vitreous irrigation with injections of antibiotics. On the postoperative day 1, anterior chamber cell decreased to 2+ and hypopyon was not observed on slit lamp examination. Six days postoperatively, the patient had recurrent eye pain, and the anterior chamber cell grade increased to 4+; hypopyon recurred in the anterior chamber, and whitish plaque was observed in the lens capsule. Therefore, the patient underwent intraocular lens (IOL) and lens capsule removal, followed by vitreous irrigation, antibiotics injection, and vitrectomy. M. luteus was identified from a lens capsule culture.

CONCLUSION

In cases of delayed-onset M. luteus-induced endophthalmitis, early vitrectomy and removal of the IOL and lens capsule may be necessary.

Keywords: Micrococcus luteus; Chronic endophthalmitis; Postoperative endophthalmitis; Case report

Core Tip:Micrococcus luteus (M. luteus)-induced endophthalmitis is very rare, and no case of delayed-onset M. luteus-induced endophthalmitis several months after phacoemulsification has been reported. Early vitrectomy, vitreous irrigation, antibiotic injection, and removal of the intraocular lens and lens capsule may be necessary to treat this condition.