Acinetobacter Baumanii Bleb-Related Endophthalmitis

The purpose of this article is to describe a single case of acute post-trabeculectomy bleb-related endophthalmitis secondary to Acinetobacter baumannii. A 74-year-old man with a history of trabeculectomy with adjunctive mitomycin C was referred by his glaucoma specialist to a private retina specialist for intraocular inflammation concerning for blebitis versus bleb-associated endophthalmitis. Anterior chamber paracentesis and vitreous tap for cultures were performed, which grew the gram-negative coccobacillus Acinetobacter baumannii on culture. He was treated with intravitreal vancomycin, ceftazidime, and dexamethasone with significant clinical improvement. Two months after initial injection, he had resolution of vitreous opacities and underwent cataract surgery with final visual acuity of 20/25 on post-surgical month one visit. Acinetobacter baumannii is an atypical cause of infectious endophthalmitis and has been reported in the literature to develop multidrug resistance and form biofilms. This rare infection poses challenges to the physician in both prompt diagnosis and appropriate treatment. Awareness of Acinetobacter baumannii and its challenges including the potential for multidrug resistance may assist in clinical decision making to provide rapid and effective care for patients.

Author(s): Mark A McAllister1, Spencer M Moore1and April E Harris2*

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