Endophthalmitis Caused by Citrobacter Species

Purpose: To investigate clinical settings, treatments, antibiotic sensitivities, and visual outcomes associated with endophthalmitis caused by Citrobacter species. Methods: Data were collected for organisms, surgical intervention, antibiotic sensitivity patterns, and final visual acuity. Results: Six eyes of 6 patients with culture-proven C. freundii (n = 4) or C. koseri(n = 2) endophthalmitis were identified. Clinical settings included cataract surgery (1 eye), cataract surgery combined with trabeculectomy (1), trauma (2), penetrating keratoplasty (1), and presumably endogenous source (1). Primary or secondary evisceration was performed in 3 eyes. Initial pars plana vitrectomy with intravitreal antibiotics was performed in 3 eyes. Final visual acuity was no light perception in 5 eyes, and 1 patient with traumatic C. koseri endophthalmitis achieved a final vision of 20/30. Conclusion: Despite treatment with appropriate antibiotics, Citrobacter endophthalmitis can be associated with a poor visual outcome. Early detection and management may improve the final visual outcome and prevent the possibility of evisceration.