A previously healthy 50-year-old man was transferred to our hospital for evaluation of acute inflammation in his right eye after ocular trauma while using a grass mower. Slit lamp examination showed 1 mm-length full thickness corneal laceration without leakage, 4+ cells and inflammatory membrane in the anterior chamber, 10% hypopyon, posterior synechiae formation, and cataract change. Upon orbital computerized tomography, a metallic intraocular foreign body in the lens was indentified. Vitrectomy, phacoemulsification, foreign body removal, anterior chamber irrigation, and intravitreal antibiotics injections of vancomycin and ceftazidime were performed. In a culture of humor from the anterior chamber grew Pantoea species. More procedures were performed, including intravitreal antibiotics injection of ceftazidime. Upon administering a course of intravenous ceftazidime, fortified ceftazidime and moxifloxacin eye drops, and oral prednisolone, the patient improved.
Anti-Infective Agents/administration & dosage ; Diagnosis, Differential ; Endophthalmitis/diagnosis/*microbiology/therapy ; Enterobacteriaceae Infections/diagnosis/*microbiology/therapy ; Humans ; Lens Implantation, Intraocular ; Male ; Middle Aged ; Pantoea/*isolation & purification ; Republic of Korea

We here in report a case of bilateral endogenous endophthalmitis caused by Pantoea agglomerans (P. agglomerans) in a patient who had interstitial lung disease and was treated with oral corticosteroids. A 72-year-old man presented with decreased visual acuity in both eyes nine days after he received oral corticosteroids. He had marked uveitis, cataracts, and vitreous opacities. Cultures were taken of blood, aqueous humor, and vitreous. We initially suspected a fungal etiology and treated him with antifungal drugs; however, the intraocular disease progressed without improvement. Vitreous culture was positive for P. agglomerans. The patient underwent pars plana vitrectomy with cataract surgery bilaterally, followed by a 2-week course of antibiotics. The final visual acuity was 20/25 in the right eye and 20/200 in the left eye. This is the first report of bilateral endogenous endophthalmitis caused by P. agglomerans in Korea; it is also the first case reported outside of the United States.
Aged ; Anti-Bacterial Agents/therapeutic use ; Endophthalmitis/complications/*microbiology/therapy ; Enterobacteriaceae Infections/complications/*microbiology/therapy ; Eye Infections, Bacterial/complications/*microbiology/therapy ; Follow-Up Studies ; Humans ; Lung Diseases, Interstitial/*complications ; Male ; Pantoea/*isolation & purification ; Visual Acuity ; Vitrectomy