Case Report: Endogenous endophthalmitis caused by Listeria monocytogenes infection in patients with end-stage renal disease

TL;DR

A rare case of Listeria monocytogenes endophthalmitis in a patient with end-stage renal disease is reported, emphasizing the need for rapid detection and timely treatment.

Contribution

This case report introduces a rare infection scenario and highlights the effectiveness of metagenomic detection and standardized treatment in managing endogenous endophthalmitis.

Findings

Endogenous endophthalmitis was diagnosed using metagenomic detection of Listeria monocytogenes in intraocular aqueous.

A combination of local and systemic treatments led to subsiding inflammation and improved visual acuity.

Timely standardized intervention is crucial for managing such rare infections in ESRD patients.

Abstract

This paper reports a rare case of endogenous Listeria monocytogenes endophthalmitis caused by hemodialysis in end-stage renal disease (ESRD).

The patient was a 70-year-old female. The best-corrected visual acuity (BCVA) was light perception (LP). Endogenous endophthalmitis was diagnosed based on clinical manifestations and auxiliary examinations. Pathogenic microbial metagenomic detection of intraocular aqueous was used to identify Listeria monocytogenes. As multiple investigations showed no source of infection, a standardized treatment plan was proposed.

The treatment included the local application of antibiotics, glucocorticoids and cycloplegic drugs, vitrectomy, intravitreal injection of vancomycin and ceftazidime, anterior chamber irrigation, and systemic antibiotic treatment after the operation. After treatment, the inflammation subsided, and the BCVA at discharge was hand movement (HM).

Our study highlights the importance of rapid pathogenic microbial metagenomic detection and timely standardized intervention in the treatment of endogenous endophthalmitis.

Figures