Endophthalmitis Caused byVibrio alginolyticus

Abstract

Vibrio alginolyticus is a facultative anaerobic gram-negative bacillus found in normal marine flora. Ocular infections induced by V. alginolyticus are extremely rare. We report a case of endophthalmitis caused by V. alginolyticus to draw attention to V. alginolyticus infections following ocular injuries. CASE REPORTA 26-year-old man was admitted to our department of ophthalmology after a fish hook bounced back and ripped into his left eye while fishing. The entrance of the scleral wound was at the 8:30 o'clock position 6 mm from the limbus. The fish hook had penetrated the sclera by about 3 cm outside the eyeball (Fig. 1). The best-corrected visual acuity (VA) was 20/20 in the right eye and 20/100 in the left. There were no signs of inflammation in the anterior chamber of the left eye. A fundus examination showed a grade I vitreous opacity in the left eye, and the preliminary diagnosis was a vitreous hemorrhage. Surgery was performed immediately to remove the fish hook (Fig. 2). The scleral wound was closed with 5-0 absorbable suture. Scleral buckling and cryopexy were performed to avoid a secondary retinal detachment. A computed tomography scan showed no radio-opaque intraocular foreign body after surgery. Considering that the contaminated fish hook penetrated the eye, 6.0 g of ampicillin was administered intravenously postoperatively to prevent infection and 10 mg dexamethasone to prevent further inflammation. At 8:00 a.m. on the first postoperative day, the VA of the affected eye was 20/150, and no inflammation developed in the anterior chamber. The patient did not report any discomfort. Tobramycin (0.3%) and 0.1% fluorometholone eye drops were instilled topically four times daily. Ampicillin and dexamethasone also were administered intravenously as previously described. Seven hours later on the first postoperative day, the patient complained of progressively blurred vision. The VA decreased to the level of hand movements, along with serious inflammation of the left eye and marked haze of the left vitreous. A fibrinous pupillary membrane formed in the anterior chamber without hypopyon. A diagnosis of posttraumatic endophthalmitis was made. The patient refused an intravitreal antibiotic injection. A 3-mm hypopyon developed within 30 min, and because the inflammation progressed quickly, pars plana lensectomy and vitrectomy were performed immediately. Intraoperatively, we found the lens was opaque and the vitreous cavity was filled with hemorrhages and veils. After cutting off the lens and most of the exudation, we found extensive full-thickness retinal necrosis, retinal vessel occlusion, and superficial hemorrhages. After clearing the vitreous cavity, we filled 12% of the vitreous cavity with perfluoropropane (C 3 F 8 ) after air gas exchange. Three hours postoperatively, the patient was transferred to a tertiary hospital.Vitreous fluid was collected during vitrectomy and plated onto blood agar. Smooth, convex, creamy colonies became evident within 24 h. On a Gram stain, the isolate was gram negative. The isol...

Distribution of Vibrio alginolyticus-like species in Shenzhen coastal waters, China

“…However, V. alginolyticus is an important bacterial pathogen of humans, causing wound infections, otitis media, otitis externa, endophthalmitis and gastrointestinal infection (11, 26, 36, 37). This bacterium also belongs to the most important opportunistic pathogens of aquatic animals, including fish, shellfish, crustaceans, coral and echinoids, causing serious disease and damage in cultured fish and important economic losses (3, 4, 12, 25, 29).…”

Vibrio alginolyticusinfections in the USA, 1988–2012

“…Although most vibriosis caused by other species is foodborne, V. alginolyticus is predominantly transmitted by water [1,6], which is reflected by geographic clustering in coastal regions [6] and multiple case reports of otitis externa and traumatic wound infections involving seawater exposure [9][10][11][12][13][14][15][16][17][18][19]36]. Significant morbidity, including multiple surgeries, prolonged antibiotic treatment, amputations, and other complications [9-11, 13, 14, 20] can occur.…”

Prevalence of Biofilm Formation and Wide Distribution of Virulence Associated Genes among Vibrio spp. Strains Isolated from the Monastir Lagoon, Tunisia

“…-externa, endophthalmitis and wound infections (Li et al, 2009;Reilly et al, 2011). It's also well documented that V. cholerae and V. parahaemolyticus are most often incriminated in food-borne and waterborne gastroenteritis outbreaks (Nair et al, 2007;Yoder et al, 2008).…”