Bilateral Endogenous Streptococcus mitis Endophthalmitis Following Dental Implant: A Case Report and Literature Review

Endogenous endophthalmitis is an intraocular inflammation caused by the hematogenous spread of microorganisms from distant foci. Streptococcus mitis is a low-virulence organism that inhabits the oral cavity; however, it has rarely been reported to cause endogenous endophthalmitis. In this case report, we present a 63-year-old woman with bilateral asymmetrical endogenous endophthalmitis and a severely affected right eye, with light perception vision, hypotony, and severe anterior and posterior segment inflammation. The left eye exhibited intraretinal infectious infiltrates and minimal vitritis. However, the cause of the S. mitis bacteremia was unclear. Considering the patient's recent dental implant procedure, we hypothesized that the bacteria may have entered the bloodstream through the oral cavity. The patient received intravitreal and systemic antibiotics and underwent pars plana vitrectomy for the right eye. In conclusion, we present a case of endogenous endophthalmitis, presumed following a dental implant procedure. S. mitis may invade the bloodstream following an uncomplicated dental procedure, leading to bilateral endogenous endophthalmitis. Early detection, prompt management with systemic and intravitreal antibiotics, and early vitrectomy may potentially preserve the patient's globe and vision.