Streptococcus intermedius-associated late-onset endophthalmitis after trabeculectomy with adjunctive mitomycin C.

Purpose: To report a woman with congenital rubella syndrome of delayed-onset, bleb-related endophthalmitis induced by Streptococcus intermedius.

Methods: Interventional case report.

Results: A 33-year-old woman who underwent bilateral trabeculectomy with adjunctive mitomycin C, 11 years earlier presented with redness and blurred vision in her right eye. She had received a topical antimicrobial agent because of bleb leak before presentation. She underwent anterior chamber tap and complete vitrectomy with intravitreal antibiotics. Cultures from the vitreous aspirate grew gram-positive cocci. The DNA from the microorganism was sequenced and identified as S. intermedius. Three months after the surgical intervention, her right eye showed no residual inflammation with a best-corrected visual acuity of 30/200.

Conclusions: Bleb-associated endophthalmitis caused by S. intermedius is responsive to intravitreal antibiotics and vitrectomy, and special care should be taken to identify a bacterial pathogen.