| 본문 : To report 2 cases of postoperative endophthalmitis caused by Streptococcus dysgalactiae subspecies equisimilis (SDSE), which showed as hyper-acute presentation and panophthalmitis.
A 68-year-old man received cataract surgery to right eye and was evaluated the next day (less than 24 hours from the surgery) because of acute loss of vision. Visual acuity of the eye was light perception and it showed corneal edema, hypopyon, and vitreous opacity. The patient underwent pars plana vitrectomy(PPV), and removal of capsular bag and intraocular lens with intravitreal antibiotic injection. Culture of vitreous revealed SDSE. After PPV, regression of inflammation was observed, though corneal edema showed progression. Cornea of the eye evolved to decompensate as bullous keratopathy and visual acuity of the eye had no light perception after 3months.
A 87-year-old man who underwent phacoemulsification and intraocular lens implantation on right eye two days previously was hospitalized due to severe ocular pain and visual loss. Visual acuity of affected eye was no light perception and it showed severe corneal edema, hypopyon, and thick vitreous opacity. The patient received only intravitreal injection of antibiotic due to severe corneal edema. Culture of aqueous humor showed SDSE. 4 days after intravitreal injection, erythema and swelling of eyelid of affected eye was observed, and diagnosed as panophthalmitis. After using intravenous vancomycin and ceftazidime, cellulitis of eyelid was resolved. The eye progressed as phthisis after 3months without recurrence.
Postoperative SDSE endophthalmitis showed aggressive and hyper-acute presentation resulted in blindness despite of prompt treatment. SDSE is emerging organisms and should be considered as potential cause of postoperative endophthalmitis.
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