A case of Legionnaire’s endophthalmitis
Received 15 August 2018
Accepted for publication 15 March 2019
Published 14 June 2019 Volume 2019:12 Pages 173—177
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Colin Mak
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Jea H Yu,1 Jaycob Avaylon,1 Hyein Kil,1 Jisoo K Kim,1 Ron P Gallemore1,2
1Department of Clinical Research, Retina Macula Institute, Torrance, CA, USA; 2Department of Ophthalmology, University of California, Los Angeles, CA, USA
Purpose: To report a case of endophthalmitis associated with Legionella Pneumophila.
Case Report: A 46-year-old, highly myopic male with a complex history of recurrent retinal detachments, macular hole, cataract surgery and an infected scleral buckle in the left eye, presented with pain, redness, hypopyon and vision loss in the left eye, 14 days following blunt head trauma. Empirical treatment for endophthalmitis with intravitreal injections of Vancomycin and Ceftazidime afforded minimal improvement. He developed recurrent hypopyon and underwent vitrectomy surgery with intravitreal antibiotic injections at the time of surgery and had improvement. Intraoperative culture was positive for Legionella Pneumophila. He had continued episodes of recurrent inflammation which were quelled by intravitreal moxifloxacin injections performed every 3–10 days. He developed a recurrent RD with proliferative vitreoretinopathy (PVR) and underwent vitrectomy with silicone oil. The retina was reattached but had no light perception vision in the affected eye.
Conclusion: When endophthalmitis is contracted in a work-place setting, a culture for L. pneumophila should be considered. A combination of intravitreal moxifloxacin and oral azithromycin may be effective.
Keywords: endophthalmitis, Legionella Pneumophila, Legionnaire’s disease
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