網膜におよぼす硫酸ゲンタマイシンの影響

取得学位 : 博士（医学）, 学位授与番号 : 医博乙第1215号, 学位授与年月日：平成5年2月17日,学位授与年：199

Brachybacterium paraconglomeratum Endophthalmitis Postcataract Operation

Purpose. To present our findings in a case of delayed-onset postoperative endophthalmitis caused by Brachybacterium paraconglomeratum, a rare organism. Observations. A 57-year-old man presented with epiphora and photophobia 17 weeks after a routine cataract extraction with phacoemulsification and intraocular lens implantation. Because endophthalmitis was suspected to be caused by a low-grade pathogen or fungus, an anterior chamber tap was performed. However, both multiplex PCR and culturing were negative. The patient was treated with topical cefmenoxime, oral minocycline, and subconjunctival injection of vancomycin and ceftazidime, but the intraocular inflammation increased. Then, the anterior chamber was tapped again, and the second PCR amplification and direct sequencing which targeted Actinomycetes detected Brachybacterium paraconglomeratum. This pathogen is uncommon for human infections. He was treated with oral amoxicillin, and his intraocular condition slowly improved. Conclusion. This is the first reported case of an ocular disorder caused by B. paraconglomeratum. We recommend that B. paraconglomeratum be considered in cases of delayed-onset postcataract endophthalmitis