Endophthalmitis caused by Serratia marcescens.

BACKGROUND AND OBJECTIVE To describe the clinical features and treatment outcomes of 10 patients with culture-proven Serratia marcescens endophthalmitis. PATIENTS AND METHODS Records from the microbiology laboratory for the period from January 1980 through June 1993 were reviewed. Ten patients were identified who had positive anterior chamber or vitreous cultures and clinical signs of endophthalmitis. The medical records for these 10 patients were reviewed, and the patients were contacted for reexamination when possible. RESULTS All 10 cases of S. marcescens endophthalmitis occurred after ocular surgery. Eight eyes received intraocular antibiotics and 2 eyes were primarily enucleated or eviscerated. All organisms were sensitive to aminoglycosides and to ceftazidime. Repeat vitreous cultures were positive in 5 cases despite appropriate initial therapy with intravitreal and intravenous antibiotics. Final visual acuity was 20/400 or better in 4 of 10 eyes. A total of 4 eyes were enucleated or eviscerated at final follow-up. Eyes with light perception or better visual acuity had a mean follow-up of 23 months. CONCLUSION S. marcescens can cause persistent endophthalmitis despite appropriate intravitreal and systemic antibiotic therapy. Eyes with S. marcescens endophthalmitis have a poor visual prognosis.