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Dr Scott and her colleagues from the Bascom Palmer Eye Institute recently reviewed the features of Mycobacterium chelonae endophthalmitis.¹ Some patients had capsular opacification and, despite therapy, remained with poor vision. I treated a patient with this infection who had similar findings and outcome, which suggests a need for further treatment improvements.

An 80-year-old woman, with a 50-pack-year smoking history, underwent extracapsular cataract surgery in the right eye with a posterior chamber intraocular lens in 1989 without intraoperative antibiotics. Three months later, she had increased discomfort with a hypopyon (Figure 1) and a pupillary membrane extending from a pocket of inflammatory material within the nasal capsular bag. Vitrectomy and aqueous tap were performed with intravitreal gentamicin and cefazolin. Vitreous culture grew M chelonae on blood, chocolate, and Sabouraud dextrose agar. Susceptibility testing showed resistance to cefoxitin, amikacin, ciprofloxacin, and doxycycline and sensitivity to tobramycin, erythromycin, and sulfisoxazole, so . . . [Full Text of this Article]

Kirk R. Wilhelmus, MD, PhD
Houston, Tex