Serratia marcescens endophthalmitis after 20-gauge pars plana vitrectomy.

PURPOSE:To describe the first reported case of endophthalmitis after 20-gauge vitrectomy caused by Serratia marcescens. METHODS:Retrospective case report. RESULTS:An 86-year-old woman underwent a standard 20-gauge vitrectomy for repair of a chronic rhegmatogenous retinal detachment. All sclerotomies were sutured at the completion of the case. Within 2 days after surgery, she developed severe endophthalmitis. A bacterial culture of her aqueous sample was positive for S. marcescens. Despite the culture-demonstrated sensitivity of this organism to the antibiotics given intravitreally, systemically, and topically to treat this infection, her condition deteriorated, and she developed panophthalmitis, orbital cellulitis, a corneal ulcer, and eventual no light perception vision. CONCLUSIONS:This is the first reported case of S. marcescens endophthalmitis after vitrectomy surgery. Endophthalmitis caused by S. marcescens has a poor visual prognosis and may show an in vivo clinical resistance to antibiotic therapy regardless of in vitro culture sensitivities.