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Streptococcus salivarius endogenous endophthalmitis
  1. Carl-Joe Mehanna,
  2. Lea Kallassi,
  3. Ahmad M Mansour and
  4. Rola N Hamam
  1. Ophthalmology, American University of Beirut Medical Center, Hamra, Lebanon
  1. Correspondence to Dr Rola N Hamam; rh46{at}


We describe a case of endogenous endophthalmitis in an elderly man caused by Streptococcus salivarius. An 88-year-old male patient with diabetes with iron deficiency anaemia and history of transcatheter aortic valve implantation presented with an insidious clinical picture of atraumatic endophthalmitis. No internal or external source could be identified. Diagnostic and therapeutic vitrectomy revealed papillomacular abscess and vitreous fluids grew S. salivarius. Despite lack of an identifiable source of infection, a high index of suspicion for atypical presentations is required in patients with multiple comorbidities that could weaken their immune system towards opportunistic infections. Early detection, microbiological evaluation and prompt treatment are critical to avoid disastrous outcomes. While S. salivarius has been implicated in cases of exogenous endophthalmitis, this is the first reported case of endogenous endophthalmitis due to S. salivarius.

  • ophthalmology
  • retina
  • infectious diseases

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  • Contributors Conceptualisation: C-JM, AMM, RNH. Data collection: C-JM, LK. Manuscript drafting: C-JM, LK. Manuscript revision: AMM, RNH. Oversight: AMM, RNH.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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