Post-Operative Endophthalmitis Caused by the Nutritionally Variant Streptococcus Granulicatella adiacens

Objective: Bacterial endophthalmitis is among the most serious ocular infections. Nutritionally variant streptococci (NVS) are bacteria that are difficult to culture with standard media because of fastidious growth requirements. The cases of post-operative endophthalmitis caused by Granulicatella adiacens, one of the NVS were reported. Method: Case report and review of literature Results: In Case 1, a 77-year-old female, who had undergone repeated ocular surgeries including trabeculectomy in the left eye, had developed late-onset bleb-related endophthalmitis without bleb leakage. The best corrected visual acuity (BCVA) showed light perception. A vitrectomy was performed, following this procedure and topical, intravitreal and systemic antibiotics, the BCVA recovered to 18/20. In Case 2, an 85-year-old male had developed acute postoperative endophthalmitis after cataract surgery in his left eye. The BCVA was light perception in the left eye. A vitrectomy and the removal of intraocular lens were performed. Inflammation was improved after the vitrectomy and administration of topical, intravitreal and systemic antibiotics. Bacteria isolated from the vitreous samples of these patients were identified as Granulicatella adiacens by the 16S ribosomal RNA gene sequencing. Conclusion: We report the first cases of post-operative endophthalmitis caused by G. adiacens identified by molecular genetic analysis. NVS should be considered in cases of post-operative endophthalmitis.