Endogenous Endophthalmitis Caused by Group B Streptococcus Following Urinary Tract Infection

Background: Endogenous endophthalmitis is a condition where infection spreads hematogenously to the eye. Group B Streptococcus (GBS) is a rare causative microorganism of endogenous endophthalmitis. A case of endogenous endophthalmitis caused by GBS secondary to urinary tract infection (UTI) is reported. Case Presentation: An 83-year-old male presented with decreased visual acuity, ocular pain, and headache in his right eye three days after experiencing lower back pain. Initial examination revealed light perception in visual acuity, intraocular pressure of 30 mmHg, hypopyon in the anterior chamber, and severe vitreous opacity in the right eye. There was no history of trauma or ophthalmic surgery. The patient had been self-catheterizing due to chronic ureteral obstruction. Aqueous and vitreous samples were collected and blood tests and a urine culture were performed for microbiological examination. On the same day as the initial visit, vitrectomy was performed. Intraoperatively, extensive retinal necrosis and total retinal detachment were observed. Gram-positive cocci were detected in the aqueous humor, and GBS was isolated from both vitreous and urine cultures. Blood tests showed elevated levels of inflammatory markers, with a C-reactive protein of 5.4 mg/dL, and undiagnosed diabetes mellitus was found. Intensive antibiotic therapy resolved the inflammation, although, visual acuity did not improve. Conclusions: Endogenous endophthalmitis was caused by GBS occurred secondary to UTI. Systemic assessment is crucial for diagnosing endogenous endophthalmitis, and early and appropriate treatment is essential.