Acute endogenous endophthalmitis caused by Streptococcus agalactiae: A case report and review.

Background: Streptococcus agalactiae is a significant pathogen responsible for invasive diseases worldwide, and its prevalence among bacteremia patients has been increasing in recent years. Endogenous endophthalmitis is rare, accounting for only 5-15 % of all endophthalmitis cases. Among the pathogenic bacteria, Streptococcus agalactiae is responsible for approximately 5.2 % of endogenous endophthalmitis cases and is often associated with a poor visual prognosis. Case presentation: We report a case of acute endogenous endophthalmitis caused by Streptococcus agalactiae. Emergency anterior chamber irrigation and intravitreal antimicrobials injection were performed, alongside systemic antibiotic therapy. Regrettably, the patient ultimately required evisceration and debridement surgery of the affected eye. Discussions: Streptococcus agalactiae can cause ocular infection presenting as acute purulent endophthalmitis. Establishing an early diagnosis and performing antimicrobial susceptibility testing are critical to guide clinicians in selecting effective antibiotic regimens. Early intervention with intravitreal antimicrobials injection or vitrectomy may help preserve vision and improve outcomes. However, in cases with irreversible local infection, enucleation or evisceration of the eye may be necessary to control the disease process and alleviate patient's symptoms.