Post Cataract Surgery Endophthalmitis in the “Constant Gardener”

Tahir A Farooq, Yajati Ghosh


We describe a case of endophthalmitis following routine cataract surgery caused by the aerobic gram negative organism, Rhizobium radiobacter. The low virulence of this organism is demonstrated through the late clinical presentation of sight-threatening signs and symptoms. This case highlights the importance of the high levels of suspicion required in postoperative cataract patients, prompt diagnosis and treatment with appropriate antimicrobials. Indeed, the array of cases reported in the literature demonstrates the varying severity of post-cataract endophthalmitis and delays in presentation. Specifically, this case highlights shifting sensitivity of R. radiobacter, from gentamicin to ciprofloxacin, and confirms that this species can be treated safely with a good visual outcome, without requiring the removal of the intraocular lens implant. Moreover, this case should remind clinicians of the need to advise patients not to undertake activities which involve exposing the eye to organic material, such as gardening, following cataract surgery.

Keywords: cataract surgery, complications, endophthalmitis, rhizobium radiobacter, agrobacterium, gardening