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TitleEndogenous Streptococcus Anginosus Endophthalmitis in an Immunocompetent Young Adult
PurposeTo report a case of slowly progressive endogenous endophthalmitis secondary to Streptococcus anginosus in an immunocompetent patient.
MethodsDescriptive case report.
ResultsA 46-year-old teacher presented with a two-month history of right eye iritis. On examination, visual acuity was 20/60 with intraocular pressure of 6 mm Hg. There was a small layer of hypopyon with non-granulomatous anterior uveitis and vitritis. On funduscopy, fluffy white peripheral retinal and pre-retinal lesions were noted in the superonasal periphery.
Pars plana vitrectomy was performed. Culture and polymerase chain reaction of vitreous samples were positive for Streptococcus anginosus. Intravitreal and systemic antibiotic therapy was instituted. Work-up which included blood and urine cultures, chest x-ray, echocardiography, and abdominal ultrasound was unyielding. Subsequently and because of a persistent post-infectious inflammatory reaction, intravitreal and oral steroids were administered in addition to azathioprine later on. After one year of follow-up, visual acuity was 20/20 with a near vision of Jaeger 3+ and no signs of active uveitis were seen.
ConclusionStreptococcus anginosus should be considered in the differential diagnosis of slowly progressive endophthalmitis also in immunocompetent patients.

Conflict of interestNo
Author 1
Last nameSANCHEZ
Initials of first name(s)JM
DepartmentOphthalmology
CityJerusalem
CountryIsrael
Author 2
Last nameDavila
Initials of first name(s)M
DepartmentOphthalmology
CityJerusalem
CountryIsrael
Author 3
Last nameHalpert
Initials of first name(s)M
DepartmentOphthalmology
CityJerusalem
CountryIsrael
Author 4
Last nameAmer
Initials of first name(s)R
DepartmentOphthalmology
CityJerusalem
CountryIsrael