Endogenous Group A Streptococcal Endophthalmitis in a Healthy 42-Year-Old Man: A Case Report.

INTRODUCTION: Endogenous endophthalmitis is a rare condition that is caused by hematogenous spread of bacteria or fungi and is usually seen in patients with predisposed medical conditions. We are reporting an unusual case of group A streptococcal infection causing endogenous endophthalmitis and septic arthritis in a healthy 42-year-old man.

CASE PRESENTATION: A previously healthy 42-year-old man presented to the Emergency Department with chills, fever, left wrist pain, left eye pain, and vision loss. Owing to the acute onset of the septic arthritis and the patient's bandemia, the Ophthalmology Department was consulted for suspicion of endophthalmitis. Blood cultures, left wrist synovial fluid cultures, and vitreous cultures grew group A streptococcus. An incision and drainage of the left wrist was performed, and intravitreal injection of vancomycin was given. The patient's vision was responsive only to light on discharge from the hospital. The patient underwent a left eye evisceration 2 months later.

DISCUSSION: Endophthalmitis provides a difficult diagnostic and therapeutic challenge. However, even with prompt treatment, visual outcomes may be poor.