Recurrent intraocular inflammation: Staphylococcus hominis endophthalmitis.

Abstract

An 84-year-old highly myopic monocular male, with remote uncomplicated extracapsular cataract surgery without intraocular lens implantation and chronic inflammatory eyelid disease, presented with presumed mild bacterial keratitis (BK), whitish retroiridian masses and associated moderate panuveitis in his right eye. Corneal and aqueous humour cultures, as well as an extensive systemic septic work-up, were negative. Combined treatment with fortified topical, intravitreal and parenteral antibiotics, together with systemic corticosteroids, achieved rapid and complete resolution. Seven months later, the same clinical picture recurred; despite prompt remission after retreatment, pars plana vitrectomy was added. No relapses occurred during 3 years of follow-up. Staphylococcus hominis was isolated from the removed whitish masses. Possible pathogenic mechanisms include bacterial sequestration within capsular remnants, recurrent culture-negative presumed BK, or even sample contamination, potentially facilitated by bacterial permanence and persistence on the ocular surface. Identification of S. hominis as a potential cause of intraocular inflammation remains exceedingly uncommon, with only a few cases reported.