Sir,
We recently encountered a rare case of post-operative Ochrobactrum anthropi endophthalmitis potentially caused by percutaneous transluminal angioplasty (PTCA) prior to cataract surgery. O. anthropi has caused catheter-associated bacteraemia, osteochondritis, and pancreatic abscess.1, 2, 3 However, we identified only a single report of O. anthropi endophthalmitis following cataract surgery in the literature.4
A 75-year-old man was referred for chronic endophthalmitis following uneventful cataract extraction and posterior intraocular lens (IOL) placement in April 2006. Medical history included myocardial infarction and PTCA 1 year previously (3 weeks before cataract surgery). Low-grade intraocular inflammation was noted on post-operative day 9 and treated with steroid drops; yet pan-uveitis persisted for 9 months. Pars plana vitrectomy, intravitreal antibiotic injection, two anterior chamber taps, and intracameral antibiotic injection were performed; the initial tap revealed O. anthropi.
Our initial evaluation (April 2007) detected keratic precipitates on the endothelium, fine white conglomerates on the IOL, and diffuse debris in the vitreous. We performed complete capsulectomy, IOL removal, vitrectomy, and intravitreal vancomycin and amikacin injection. Vitreous and capsular bag cultures grew O. anthropi sensitive to ceftazidime, imipenem, ciprofloxacin, and trimethoprim. Therapy included intravenous Tieman and topical ciprofloxacin. The infection cleared, and vision recovered from 4/20 to 2/20 with spectacles.
Ochrobactrum anthropi sepsis usually occurs with indwelling catheters or other medical prostheses.5 Our patient could have been infected during cataract surgery or PTCA; O. anthropi infections manifesting within 3 weeks of central venous catheter placement and within 70 days of mitral valvuloplasty have been reported.6, 7 Our patient received PTCA 3 weeks before cataract surgery and symptoms occurred within 10 days. We assume that O. anthropi clustered in the vitreous first, then circulated to the anterior segment.
Our patient received cataract surgery at another clinic; so his blood culture results were unavailable. To reduce the risk of infection, surgeons should evaluate the patient's complete detailed medical history prior to surgery. A recent vascular catheter procedure represents a risk for O. anthropi infection.
References
Saavedra J, Garrido C, Folgueira D, Torres MJ, Ramos JT . Ochrobactrum anthropi bacteremia associated with a catheter in an immunocompromised child and review of the pediatric literature. Pediatr Infect Dis J 1999; 18: 658–660.
Cieslak TJ, Robb ML, Drabick CJ, Fischer GW . Catheter-associated sepsis caused by Ochrobacterium anthropi: report of a case and review of related nonfermentative bacteria. Clin Infect Dis 1992; 14: 902–907.
Sipahi OR, Calik S, Mazharoğullari K, Aydemir S, Yamazhan T, Tekeşin O . Ochrobactrum anthropi bacteremia developed after cholangiopancreatography. Mikrobiyol Bul 2007; 41: 469–472.
Braun M, Jonas JB, Schönherr U, Naumann GO . Ochrobactrum anthropi endophthalmitis after uncomplicated cataract surgery. Am J Ophthalmol 1996; 122 (2): 272–273.
Gill MV, Ly H, Mueenuddin M, Schoch PE, Cunha BA . Intravenous line infection due to Ochrobactrumanthropi(CDC Group Vd) in a normal host. Heart Lung 1997; 26: 335–336.
Berman AJ, Del Priore LV, Fischer CK . Endogenous Ochrobactrumanthropiendophthalmitis. Am J Ophthalmol 1997; 123: 560–562.
Inoue K, Numaga J, Nagata Y, Sakurai M, Aso N, Fujino Y . Ochrobactrum anthropi endophthalmitis after vitreous surgery. Br J Ophthalmol 1999; 83: 502.
Greven CM, Nelson KC . Chronic postoperative endophthalmitis secondary to Ochrobactrum anthropi. Retina 2001; 21: 279–280.
Author information
Authors and Affiliations
Corresponding author
Additional information
The authors have no proprietary or financial interest in any material or device mentioned.
Rights and permissions
About this article
Cite this article
Chiang, CC., Tsai, YY., Lin, JM. et al. Chronic endophthalmitis after cataract surgery secondary to Ochrobactrum anthropi. Eye 23, 1237–1238 (2009). https://doi.org/10.1038/eye.2008.137
Published:
Issue Date:
DOI: https://doi.org/10.1038/eye.2008.137
This article is cited by
-
Triple Gram-negative bacterial endophthalmitis following intravitreal injection
Journal of Ophthalmic Inflammation and Infection (2024)
-
Chronic postoperative endophthalmitis after cataract surgery secondary to vancomycin-resistant Ochrobactrum anthropi: case report and literature review
Journal of Ophthalmic Inflammation and Infection (2016)