Gemella species-associated late-onset endophthalmitis after trabeculectomy with adjunctive mitomycin C

J Glaucoma. 2009 Aug;18(6):496-7. doi: 10.1097/IJG.0b013e31818c6f07.

Abstract

Purpose: To report 2 cases of delayed-onset, bleb-related endophthalmitis induced by Gemella species.

Methods: Interventional case report.

Results: Two patients developed bleb-related ocular infection attributable to Gemella haemolysans and Gemella morbillorum after trabeculectomy with adjunctive mitomycin C. Both patients had thin-walled cystic filtering blebs before ocular infection. One patient underwent urgent vitrectomy with intravitreal injection of ceftazidime and vancomycin. The other received an intraocular injection of vancomycin and ceftazidime. After surgical intervention, 2 cases were administered topical levofloxacin and sulfobenzylpenicillin, and intravenous cefpirome. The DNA from the microorganism was sequenced and identified as G. haemolysans and G. morbillorum.

Conclusions: Gemella species should be added to the long list of organisms that may rarely cause bleb-associated endophthalmitis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Blister / microbiology
  • Conjunctiva / surgery
  • Drug Therapy, Combination
  • Endophthalmitis / diagnosis
  • Endophthalmitis / drug therapy
  • Endophthalmitis / microbiology*
  • Eye Infections, Bacterial / diagnosis
  • Eye Infections, Bacterial / drug therapy
  • Eye Infections, Bacterial / microbiology*
  • Female
  • Gram-Positive Bacterial Infections / diagnosis
  • Gram-Positive Bacterial Infections / drug therapy
  • Gram-Positive Bacterial Infections / microbiology*
  • Humans
  • Male
  • Middle Aged
  • Mitomycin / administration & dosage*
  • Postoperative Complications*
  • Staphylococcaceae / isolation & purification*
  • Surgically-Created Structures / microbiology
  • Trabeculectomy*
  • Vitrectomy

Substances

  • Anti-Bacterial Agents
  • Mitomycin