Post-traumatic endophthalmitis involving Clostridium tetani and Bacillus spp

PURPOSE: To report a case of post-traumatic infectious endophthalmitis caus ed by Clostridium tetani and Bacillus spp. METHODS: Case report. RESULTS: A 25-year-old man developed endophthalmitis after a traumatic corn eoscleral laceration of his right eye by a concrete reinforcement bar. He u nderwent pars plana lensectomy and vitrectomy with aspiration of vitreous f luid and a conjunctival swab for cultures. Cultures from the conjunctival s wab were negative for organisms, Cultures of the vitreous aspirate were pos itive for Bacillus species and C, tetani. He had. received a tetanus toroid booster at the emergency department, By the time the culture results becam e available, he had developed severe eye pain associated with marked orbita l congestion, increased swelling and erythema of the lids, marked injection and chemosis of the conjunctiva, and subsequently underwent evisceration, The inflammation resolved after evisceration of the right eye, and he was d ischarged to home on doxycycline 100 mg orally two times daily for 10 days. CONCLUSION: We are unaware of previous reports of endophthalmitis involving C tetani and could find none in a computerized MEDLINE search. Patients wi th penetrating eye injury should be assessed for tetanus immunization statu s, and early intervention with tetanus toroid booster and/or tetanus immune globulin should be considered if cultures are positive. (Am J Ophthalmol 2 001;132:116-117. (C) 2001 by Elsevier Science Inc. All rights reserved.).