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L. Wang, W. He, L. Ma, N. Dong; Endophthalmitis Caused By Chromobacterium Violaceum: A Case Report . Invest. Ophthalmol. Vis. Sci. 2006;47(13):5289.
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Chromobacterium violaceum can cause life–threatening infection and is confined in tropical and subtropical region. It typically infects hosts via skin lesion, wounds, cervical abscess, pharynx, or/and conjunctiva and may serve as the initial site of an ultimately fatal infection. No intraocular infection of this organism was reported previously. Hear,we report a first case of intraocular infection of Chromobacterium violaceum.
A 75–year–old male patient complained of rapid vision decreasing in the right eye without pain five days after operation of phaco–emmulsification of cataract and Capsular Bag–fixated IOL implantation on right eye. Infectious endophthalmitis was diagnosed. Vitrectomy was performed as emergency case and Vitreous humor culture was performed to detect broad ranges of infection including Chromobacterium violaceum.
Physical examination showed that the visual acuity in the right eye was CF/30cm. The eyeball was congestion accompanied by edema of the upper lid and the cornea was edematous moderately. The anterior surface of IOL was coverd by a lot of exudate and hypopyon was present at the lower region of anterior chamber. The pupil was 1.0 mm in diameter and the fundus could not be examined due to opacity of the ocular refractive media. Pain in the right eye was not complained of. The general examination including thoracic, abdomen and extremities was normal. B–scan of the right eye showed severe vitreous opaque . Both temperature measuring and blood routine examination were normal. Vitreous culture confirmed and yielded Chromobacterium violaceum. Vancomycin had been administered through IV (15mg/kg, q12h) and injected into subconjunctiva (25mg, qd) for three days, then vitrectomy was performed. Two days Post operation, Ceftazidime was administered through IV (2g,q8h))and eye drops of Ciprofloxacime was applied according to MIC of medicine sensitive test. The intraocular infection was controlled and the visual acuity in the right eye increased to 20/200 when the patient was discharged.
Chromobacterium violaceum should be recognized as a potentially pathogen in ocular infectious diseases.Vitrectomy and sensitive antibiotic therapy are good remedy in the treatment of intraocular infection due to this kind of organism .Ophthalmologists should be aware of this bacteria infection occurred in summer.
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