Propionibacterium acnes Endophthalmitis
A chronic infectious endophthalmitis may develop following cataract surgery. Common causative organisms are Propionibacterium acnes, Staphylococcus epidermidis, and fungi. Chronic postoperative bacterial endophthalmitis is most commonly caused by P acnes; P acnes endophthalmitis often has a delayed presentation, usually between 2 months and 2 years following surgery. The organism, a gram-positive coccobacillus that is part of normal skin flora and grows best in anaerobic conditions, may sequester itself between a posterior chamber lens implant and the posterior capsule. In this relatively anaerobic environment, P acnes grows and forms colonies. Histologic examination of the lens capsule reveals sequestration of the bacteria within the capsule (Fig 9-5). See BCSC Section 9, Uveitis and Ocular Inflammation, Section 11, Lens and Cataract, and Section 12, Retina and Vitreous, for additional discussion of endophthalmitis.
Excerpted from BCSC 2020-2021 series: Section 4 - Ophthalmic Pathology and Intraocular Tumors. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.