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β-defensins are innate antimicrobial peptides found in a variety of ocular tissues and are critical to the immune response.1–3 We present a case of bilateral endophthalmitis and show the carriage of the –44CC genotype in β-defensin 1. The polymorphism has previously been linked to increased susceptibility to infection.4–7
An 80-year-old man underwent cataract surgery in the right eye complicated by a capsular tear. Within 4 days he returned with a hypopyon, painful loss of vision and reddening of the right eye. Endophthalmitis was diagnosed, an urgent vitreous tap was performed and intravitreal cetazidime and vancomycin were started. Microscopical examination revealed Gram-positive cocci, but no final growth of organisms. The right eye responded to treatment, but 1 month later a retinal detachment was diagnosed in the same eye. This was surgically repaired without complications. A year later, after an uncomplicated left cataract surgery in another hospital, the patient presented again with endophthalmitis symptoms, including hypopyon, rapid visual loss (hand movements), pain and reddening of the …
This study has been approved by The Central and South Bristol Research Ethics Committee, United Bristol Healthcare NHS Trust, and informed consent has been attained, in accordance with the Declaration of Helsinki.
As the patient has since passed away, informed consent for this work was obtained from the patient’s next-of-kin. We believe that this, coupled with the complete anonymity of patient within the case report, is sufficient for publication of this work.
Funding: This research was generously supported by The Underwood Trust.
Competing interests: None declared.
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