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Samuel Yun, Muge Kesen; Granulicatella Adiacens bleb-associated endophthalmitis. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2350.
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© ARVO (1962-2015); The Authors (2016-present)
Granulicatella Adiacens is a type of nutritionally variant Streptococci and part of normal flora in oral mucosa that requires Vitamin B6 (Pyridoxine) in order to grow.1 Although well known to cause treatment resistant-culture negative endocarditis, there is paucity of its reports in ophthalmology literature.2 We report another case of G. Adiacens and literature review to increase awareness of its importance in culture negative endophthalmitis and its tolerance in penicillin and vancomycin3.
A case report and review of literature
72 year old man presented with acute endophthalmitis in the setting of history of glaucoma implant and scleral contact lens wear for keratoconus. Although initially culture negative, subculture result revealed G. Adiacens as a causative organism, which was successfully treated with emergent pars plana vitrectomy (PPV), two repeat intravitreal injections (IVI) of Vacomycin and Cefatazadime, and systemic vancomycin and cefepime. In the literature review, 83 year old man with endophthalmitis from cataract surgery was successfully treated with emergent PPV and IVI of Vancomycin and Amikacin with complete recovery.4
One should suspect G. Adiacens in endophthalmitis with pleomorphic gram stain and negative culture result.1 Given tolerance to penicillin and vancomycin, one may consider aminoglycoside in case of treatment resistant endophthalmitis.3
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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