ENDOGENOUS ENDOPHTHALMITIS CAUSED BY METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS (MRSA)

Purpose: To report clinical features, diagnostic features, and outcome in three patients presenting with fulminant endogenous endophthalmitis caused by methicillin-resistant Staphylococcus aureus. Methods: Retrospective review of clinical data and microbiological findings in three cases. Results: All three patients had predisposing conditions for endogenous endophthalmitis (B-cell lymphoma, diabetes mellitus, steroid therapy, or gastrointestinal symptoms, such as vomiting and diarrhea). Two patients were colonized by methicillin-resistant Staphylococcus aureus in typical sites (nose, groin, throat, and conjunctiva), whereas one patient who developed phlebitis at the infusion puncture site followed by bacteremia presented no typical colonization. Despite adequate therapy, two patients lost visual function in the infected eye, one of which had to be enucleated. The other patient's eye regained adequate function. Conclusion: Endogenous endophthalmitis by methicillin-resistant Staphylococcus aureus is a rare but serious condition. Early and specific therapy based on reliable detection of the underlying microorganism may help in preventing loss of visual function. RETINA 29:831-834, 2009