NOVEL CASE OF CLOSTRIDIUM PERFRINGENS ENDOPHTHALMITIS AFTER ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR INJECTION.

Varsha R Kadaba, Jayshree Menon

Retinal cases & brief reports 2020

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Endophthalmitis after anti-vascular endothelial growth factor injection is a rare complication but may lead to rapid destruction of structures within the eye. Infection with Clostridium perfringens has not previously been reported in this context. A 90-year-old woman presented with endophthalmitis of the right eye, 2 days after an intravitreal injection of ranibizumab. Initial examination showed a high intraocular pressure, refractive to topical treatment, reduced vision, and a hypopyon. Gram stain showed a Gram-positive bacillus, which was identified as C. perfringens. Despite the use of intravitreal and intravenous antibiotics, the patient went on to develop cornea-scleral melt of the right eye. She required an evisceration on the fifth day after ranibizumab. This case describes a unique and virulent pathogen leading to globe loss after an anti-vascular endothelial growth factor injection. C. perfringens, naturally living in feces or soil, is more commonly associated with dirty traumatic open-globe injuries. However, it is an important pathogen to consider when there is rapid destruction of eye structures associated with endophthalmitis. Based on a root cause analysis of this case, our department has introduced patient information leaflets on hand hygiene to educate patients having intraocular injections.

Citation

Varsha R Kadaba, Jayshree Menon. NOVEL CASE OF CLOSTRIDIUM PERFRINGENS ENDOPHTHALMITIS AFTER ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR INJECTION. Retinal cases & brief reports. 2020;14(2):181-182