First report of Raoultella ornithinolytica endophthalmitis.

Abstract

Purpose: This report aims to document a rare case of endophthalmitis caused by Raoultella ornithinolytica, emphasizing its clinical presentation, diagnostic considerations, and the challenges encountered in managing this emerging ocular pathogen.

Methods: Clinical examination, imaging studies, surgical interventions, microbiological analysis, and antibiotic susceptibility testing were employed to diagnose and manage the case.

Results: A 50-year-old male presented with severe pain and vision loss following a projectile injury to the right eye. Initial examination revealed a self-sealed full-thickness corneal laceration, posterior subluxation of the lens, and the presence of a hyperdense intraocular foreign body (IOFB). The patient underwent vitreoretina interventions, including anterior chamber wash, vitreous biopsy, pars plana lensectomy, and vitrectomy with silicone oil injection, during which the metallic IOFB was removed. Raoultella ornithinolytica was identified through vitreous fluid culture, presenting a unique challenge due to limited literature on its ocular manifestations. Despite prompt surgical interventions and tailored antibiotic therapy, the infection was effectively managed, but the retina remained detached under oil at 2 months postoperatively.

Conclusion: This case highlights the importance of recognizing and managing uncommon pathogens such as Raoultella ornithinolytica in ocular infections, underscoring the need for vigilant diagnostic and therapeutic approaches tailored to antimicrobial susceptibility profiles.