ArticleFrontiers in medicine2026
Case Report: Delayed-onset and recurrent infectious endophthalmitis after intravitreal dexamethasone implant.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: To report a rare case of delayed-onset infectious endophthalmitis occurring 33 days after an intravitreal dexamethasone implant (Ozurdex®), with recurrence 20 days after complete pars plana vitrectomy and implant removal. Methods: Case report with clinical findings, diagnostic workup, management, and literature review. Results: A 51-year-old male with recurrent anterior uveitis received a dexamethasone implant for refractory cystoid macular edema. Thirty-three days post-injection, he developed acute hypopyon and severe vitritis. Emergent 25-gauge pars plana vitrectomy with implant removal was performed. Aqueous humor metagenomic next-generation sequencing (mNGS) confirmed Staphylococcus epidermidis (24,904 reads; 99.96% relative abundance), with no resistance genes detected. Postoperatively, inflammation initially resolved; however, hypopyon recurred 20 days after vitrectomy. A 6-day course of intravenous vancomycin achieved complete resolution. At final follow-up, best-corrected visual acuity improved to 20/33, with no further recurrence. Conclusion: Endophthalmitis following corticosteroid implants may present with delayed-onset and can recur even after complete surgical removal. Systemic antimicrobial therapy may play a crucial role in eradicating residual infection in such challenging cases.
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