Abstract
An 80-year-old woman presented with right endophthalmitis, characterized by chalky white deposits covering her posterior capsule. This occurred 17 months after uncomplicated right cataract surgery. A three-port pars plana vitrectomy and partial posterior capsulectomy isolated Bacillus circulans, and the patient made a rapid and full recovery on topical cephalothin and prednisolone acetate 1%. The case demonstrates that, unlike endophthalmitis due to other Bacillus spp., B. circulans endophthalmitis does not necessarily follow a fulminant course. It is the first report describing a subacute presentation, and response to posterior capsulectomy and simple antibiotic therapy It is also the first description of B. circulans causing white plaques in the posterior capsule, a finding characteristic of chronic endophthalmitis and previously considered pathognomonic of Proprionibacterium acnes endophthalmitis.
MeSH terms
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Aged
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Aged, 80 and over
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Anti-Infective Agents / therapeutic use
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Bacillaceae Infections / diagnosis
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Bacillaceae Infections / drug therapy
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Bacillaceae Infections / microbiology*
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Bacillus / isolation & purification*
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Cephalosporins / therapeutic use
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Cephalothin / therapeutic use
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Drug Therapy, Combination
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Endophthalmitis / diagnosis
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Endophthalmitis / drug therapy
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Endophthalmitis / microbiology*
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Eye Infections, Bacterial / diagnosis
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Eye Infections, Bacterial / drug therapy
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Eye Infections, Bacterial / microbiology*
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Female
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Glucocorticoids / therapeutic use
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Humans
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Lens Capsule, Crystalline / microbiology
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Lens Capsule, Crystalline / pathology
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Lens Capsule, Crystalline / surgery
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Microbial Sensitivity Tests
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Ofloxacin / therapeutic use
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Prednisolone / analogs & derivatives*
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Prednisolone / therapeutic use
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Vitrectomy
Substances
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Anti-Infective Agents
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Cephalosporins
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Glucocorticoids
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prednisolone acetate
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Prednisolone
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Ofloxacin
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Cephalothin