HAEMOPHILUS-APHROPHILUS BLEB INFECTION AFTER A MITOMYCIN TRABECULECTOMY

Background: Haemophilus aphrophilus is a rare cause of ocular infectio n. It has been reported once as a cause of late-onset endophthalmitis in a patient with an inadvertent bleb after cataract surgery. We prese nt a case of Haemophilus aphrophilus bleb infection after a mitomycin trabeculectomy. Methods: A 56-year-old woman presented with a bleb inf ection 10 weeks after a mitomycin C augmented trabeculectomy at a Univ ersity tertiary referral practice of one of the authors (GET). The cau sative organism was Haemophilus aphrophilus, identified by the Toronto Public Health Laboratory, Ontario, Canada. Results: The bleb infectio n resolved following topical, subconjunctival and intravenous antibiot ic therapy. A formal bleb revision was required to repair a persistent bleb leak. Conclusion: Patients who have had trabeculectomies augment ed with mitomycin C may be predisposed to bleb infection with unusual organisms. Prompt diagnosis and treatment is necessary to control the infection. Increased awareness and communication with laboratory perso nnel may increase the isolation of this fastidious organism.