Earliella scabrosa-associated postoperative Endophthalmitis after Phacoemulsification with intraocular lens implantation: a case report

BACKGROUND Postoperative endophthalmitis after cataract surgery is a severe eye infection that can lead to irreversible blindness in the affected eye. The characteristics, treatment and prognosis of this disease vary because of its association with different pathogens. Here, we report what is possibly the first case of endophthalmitis after cataract surgery to be associated with the rare pathogen Earliella scabrosa. CASE PRESENTATION A 56-year-old man from Hainan Island (China) with a history of phacoemulsification and type II diabetes mellitus underwent intraocular lens (IOL) implantation. He later presented with progressive endophthalmitis in his right eye. IOL explantation with capsular bag removal and a 23G pars plana vitrectomy combined with a silicone oil tamponade was performed. The infection was cleared without recurrence, and the patient's visual acuity improved from light perception to 20/200 in the right eye. An in vitro culture determined that the causative pathogen was Earliella scabrosa, and this result was confirmed by an internal transcribed spacer (ITS) sequence analysis. CONCLUSION Earliella scabrosa has never been reported as an infectious agent in human eyes, and its clinical significance remains unknown. Here, we report a rare case of Earliella scabrosa-associated endophthalmitis after cataract surgery. The fungal infection presented as an acute attack and was successfully treated with vitrectomy.