International Medical Case Reports Journal (Aug 2017)
Feline-transmitted Staphylococcal hyicus endophthalmitis after clear lens extraction: a case report
Abstract
Shih-Chun Chao,1–3,* Chia-Yi Lee,1,* Chan-Wei Nien,1 Shih-Hao Tzeng,1 Hung-Yu Lin1,4–6 1Department of Ophthalmology, Show Chwan Memorial Hospital, Changhua, Taiwan, Republic of China; 2Department of Electrical and Computer Engineering, National Chiao Tung University, Hsinchu, Taiwan, Republic of China; 3Department of Optometry, Central Taiwan University of Science and Technology, Taichung, Taiwan, Republic of China; 4Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, Republic of China; 5Department of Optometry, Chung Shan Medical University, Taichung, Taiwan, Republic of China; 6Department of Optometry, Yuanpei University of Medical Technology, Hsinchu, Taiwan, Republic of China *These authors contributed equally to this work Background: Postoperative endophthalmitis is a dreaded postsurgery complication which may lead to legal blindness. In addition to typical risk factors, some minor episodes may also lead to the occurrence of endophthalmitis. The purpose of the current study was to report a case of acute postoperative endophthalmitis caused by Staphylococcus hyicus in a patient with a contact history of felines.Case presentation: A 58-year-old Taiwanese female who had a history of contact with felines due to her occupation had received clear lens extraction surgery of the left eye on July 10, 2015. One day after the surgery, the best-corrected visual acuity (BCVA) of the left eye was 20/40, which rapidly deteriorated to light perception with hypopyon formation. She was admitted for acute postoperative endophthalmitis and received antibiotic therapy with topical levofloxacin instillation and intravitreal vancomycin plus amikacin injection. Trans pars plana vitrectomy (TPPV) was then performed 1 day after admission. The specimen obtained from the vitreous and anterior chambers yielded the growth of S. hyicus. The patient was discharged with BCVA measured by counting fingers. Another TPPV was arranged for the persistent vitreous opacity on October 20, 2015, and the BCVA recovered to 20/32 at the last visit.Conclusion: To our knowledge, this is the first case of acute postoperative endophthalmitis caused by S. hyicus due to feline contact. Unusual pathogens in the environment and personal hygiene status should be validated preoperatively to prevent the development of postoperative endophthalmitis. Keywords: Staphylococcal hyicus, feline, endophthalmitis, clear lens extraction
