1. Endogenous endophthalmitis associated to St. agalactiae
Rafael Yuste Ballesta
Mercedes Hernández Martínez
José María Marín Sánchez
Marcos Ruiz Sánchez
HCUVA Murcia

2. Case report Complicated with retroperitoneal hemorrhage
Bedridden 72-year-old man
Personal History
1- Rheumatic fever
2- Complicated valve exchange in 2012
Current illness
Diagnosis: sepsis and endocarthitis by St. agalactiae
Treatment: Intravenous Ceftriaxone 2 g/day
Complicated with retroperitoneal hemorrhage
Derived to our hospital for lumbar artery clamping

3. Ophthalmology consultation required
Persistent visual loss and painfull red RE since 1 week
Multiple catheters and Blood culture: A. baumanii (+)
RE vitritis
LE normal
RE VA 0.25
vitreous haze +3
Endogenous endophthalmitis
Diagnostic and therapeutic PPV in RE

4. Diagnostic and Therapeutic PPV in RE
- PPV 23G
- Intravitreal treatment
Voriconazol 100 μg / 0.1 ml
Ceftazidime2,25 mg /0,1 mL
Vancomicine 1 mg / 0,1mL
Vitreous condensation

5. Some small vitreous peripherical condensations
RE 1 day after surgery
RE VA 0.16
Vitreo – retinal abscess
Some small vitreous peripherical condensations

6. Negative vitreous cultures!!!
1 week after - surgery
Montaje FO
RE VA 0.8
Negative vitreous cultures!!!

7. CONCLUSIONS
Endogenous endophthalmitis should be seen as a systemic infection.
We decided to agree intravitreal Voriconazol
due to a suspected fungal ethiology.
PPV accelerates the healing process as happened in our case.