Acute-Onset Postoperative Herpetic Endophthalmitis: A Case Report

Herpes simplex virus uveitis without corneal reactivation is more frequent than previously thought. Although herpes has been implicated as a cause of postoperative and endophthalmitis, it not reported acute endophthalmitis within the early period, specifically one week following cataract extraction. A 55-year-old man with vascularized irregular central disc-shaped stromal opacity complicated cataracts underwent surgery. Intraoperatively, there was posterior capsular rent, requiring anterior vitrectomy. On day three, patient had an increase in inflammation chamber (grade 4+) marked vitreous haze 4). Vitreous taps were negative for bacteria fungi, despite intravitreal injections vancomycin ceftazidime, worsening increasing exudates appearance fibrinous membrane chamber. Polymerase chain reaction (PCR) aqueous samples at this point time yielded positive serology viral DNA, started on oral valacyclovir. The ocular resolved soon after switching to Typical starts two seven days surgery, most common isolate biopsies coagulase-negative staphylococci. We report rare case acute-onset herpetic presenting 72 hours surgery history pre-existing healed keratitis. Our highlights that suspicion should be kept mind post-cataract especially cases fail yield result Gram’s stain, culture or PCR fungi.