水晶体嚢外摘出術後に見られたpropionibacterium acnesと表皮ブドウ球菌感染による限局性眼内炎の1例

A case of localized endophthalmitis due to Propionibacterium acnes and Staphylococcus epidermidis following extracapsular cataract extraction

　水晶体嚢外摘出術（以下ECCE）後9ヵ月後に発症し，臨床的に水晶体過敏性眼内炎と全く同様の所見と経過を示し，水晶体嚢全摘出時に得た検体より，propionibacterium acnesと表皮ブドウ球菌が同定され，組織像でも細菌が認められ，限局性眼内炎と思われた1症例を経験した．その組織像では水晶体嚢内に細菌が認められた以外は，水晶体過敏性眼内炎のそれと同様であった．従来から言われている水晶体過敏性眼内炎の中には，このような弱毒菌による慢性眼内炎が含まれている可能性がある．

A 71-year-old female presented with mild iridocyclitis 9 months after uneventful planned extracapsular cataract extraction in her right eye. She was diagnosed as phacoanaphylactic endophth-almitis. Prompt improvement followed after topical instillation of corticosteroids. Episodes of hypere-mia, ocular pain and blurring of vision recurredthree times during the ensuing 12 months. Persistent iridocyclitis with hypopyon necessitated surgical removal of residual lens material. Propionibacter-ium acnes and Staphylococcus epidermidis were identified from culture and histological specimen obtained during surgery. The histological findings were otherwise identical with phacoanaphylactic endophthalmitis.

The findings indicate that postsurgical bacterial intraocular infection may masquerade clinically as phacoanaphylactic endophthalmitis.

Rinsho Ganka (Jpn J Clin Ophthalmol) 42(8) : 931-935, 1988