Oxacillin-resistant Staphylococcus aureus endophthalmitis after ganciclovir intraocular implant

PURPOSE: To describe a patient who developed oxacillin-resistant Staphyloco ccus aureus endophthalmitis after insertion of a ganciclovir intraocular im plant. METHOD: Case report. RESULTS: A 42-year-old man with acquired immunodeficiency syndrome (AIDS) a nd a history of cytomegalovirus retinitis was admitted with right-sided eye pain and decreased visual acuity 10 days after receiving a second ganciclo vir intraocular implant in the right eye, A therapeutic vitrectomy, right e ye, was performed on the day of admission. A vitreal tap produced frank pus and white, fluffy debris. Cultures of the vitreal fluid grew oxacillin-res istant S aureus, sensitive only to vancomycin, ri fampin, and trimethoprim/ sulfamethoxazole. The patient was successfully treated with removal of both ganciclovir implants in the right eye and a 4-week course of vancomycin an d rifampin, However, the infection left the patient blind in the infected e ye. CONCLUSION: Bacterial endophthalmitis is an infrequent but serious complica tion of the ganciclovir intraocular implant. (Am J Ophthalmol 2000;129:554- 555. (C) 2000 by Elsevier Science Inc. All rights reserved,).