Because of the fluffy white spots on the posterior capsule, there was a suspicion of chronic endophthalmitis FROM an indolent organism. A vitreous biopsy specimen was taken. The intraocular lens implant and capsular bag were removed via a corneal wound and sent for cultures. A pars plana vitrectomy was then performed and the posterior hyaloid face stripped FROM the retina. Subconjunctival cefuroxime and betnesol were given after the procedure.
Vitreous no organisms on gram stain or culture.
Microscopy/gram staining: fluid FROM IOL and capsular wash showed gram positive cocci.
Overnight culture produced no growth.
Day 6: gram positive pleomorphic rods were seen.
The organisms were sensitive to penicillin, ciprofloxacin and vancomycin, they were resistant to metranidazole.