Recurrent endogenous endophthalmitis caused by Mycobacterium novocastrense in an immunocompetent adult: a case report

Abstract Endophthalmitis is a serious intraocular infection, and endogenous cases occur when organisms cross the blood-ocular barrier via the bloodstream. Non-tuberculous mycobacterium (NTM) endophthalmitis typically presents as persistent intraocular inflammation. We report a case of a healthy male in his early thirties who presented with sudden onset, painful diminution of vision in his right eye, with no significant history of trauma or intravenous drug abuse. Clinical examination and ultrasound features were helpful in diagnosing endophthalmitis of endogenous origin due to the absence of a history of trauma or intraocular intervention. Following lensectomy, vitrectomy, silicone oil injection, and appropriate intravitreal antibiotics, his vision improved. Vitreous culture revealed atypical mycobacterium, Mycobacterium Novocasterence growth. Recurrences were treated with intravitreal targeted newer-generation antibiotics. The patient finally obtained best corrected visual acuity of 6/18. Timely recognition of this pathogen and management based on antibiotic sensitivity can help salvage functional vision in such patients.