{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T01:36:01Z","timestamp":1772156161288,"version":"3.50.1"},"reference-count":19,"publisher":"Microbiology Society","issue":"5","license":[{"start":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T00:00:00Z","timestamp":1748304000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,27]]},"abstract":"<jats:p>\n                    <jats:bold>Introduction.<\/jats:bold>\n                    To describe two cases of crystalline lens dislocation as a presenting feature of invasive group A\n                    <jats:italic>Streptococcus<\/jats:italic>\n                    (GAS) infection and its management.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Case presentation.<\/jats:bold>\n                    We report on a 58-year-old woman and a 36-year-old man who presented in 2024 with acute vision loss and severe ocular and systemic symptoms. Both patients were found to have lens dislocation and were diagnosed with invasive GAS infection. The 58-year-old woman had a complicated clinical course leading to enucleation, while the 36-year-old man responded favourably to early and aggressive treatment with systemic and intravitreal antibiotics. The responsible GAS strains were sequence type (ST) 28 and ST433, respectively.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion.<\/jats:bold>\n                    These cases highlight the importance of recognizing crystalline lens dislocation as a potential sign of ocular GAS infection. Two specific strain types of GAS associated with these findings, ST28 and ST433, are reported. In patients with GAS sepsis presenting with corneal oedema and zonular loss, clinicians should immediately initiate treatment, including intravitreal antibiotic injections and systemic therapy. Prompt and aggressive management can be crucial in preserving ocular structures.\n                  <\/jats:p>","DOI":"10.1099\/acmi.0.000903.v4","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T12:15:43Z","timestamp":1748348143000},"source":"Crossref","is-referenced-by-count":0,"title":["Crystalline lens dislocation as a presenting sign of Streptococcus pyogenes invasive infections"],"prefix":"10.1099","volume":"7","author":[{"given":"Paulina","family":"Liberman","sequence":"first","affiliation":[{"name":"Ocular Immunology Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob G.","family":"Light","sequence":"additional","affiliation":[{"name":"Patient Access Center for the Eye, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shazia","family":"Dharssi","sequence":"additional","affiliation":[{"name":"Oculoplastics Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tracy","family":"Howard","sequence":"additional","affiliation":[{"name":"Microbiology Laboratory, Johns Hopkins Hospital, Baltimore, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Lu","sequence":"additional","affiliation":[{"name":"Microbiology Division, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia J.","family":"Simner","sequence":"additional","affiliation":[{"name":"Microbiology Division, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, USA"},{"name":"Microbiology Laboratory, Johns Hopkins Hospital, Baltimore, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen C.","family":"Carroll","sequence":"additional","affiliation":[{"name":"Microbiology Division, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, USA"},{"name":"Microbiology Laboratory, Johns Hopkins Hospital, Baltimore, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheng-Ying","family":"Ho","sequence":"additional","affiliation":[{"name":"Division of Neuropathology and Ophthalmic Pathology, Department of Pathology, Johns Hopkins Hospital, Baltimore, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"345","reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajoc.2017.07.004"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1016\/j.survophthal.2023.02.001"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiac.2019.06.008"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2005.12.024"},{"key":"R5","article-title":"Epidemiological alert: Invasive disease caused by group A streptococci [accessed June 2024]","year":"2023"},{"key":"R6","article-title":"Increase in Pediatric Invasive Group A Streptococcal Infections","year":"2022"},{"key":"R7","article-title":"Increase in Invasive Group A Strep Infections, 2022-2023 [accessed June 2024]","year":"2023"},{"key":"R8","article-title":"Increased incidence of scarlet fever and invasive Group A Streptococcus infection - 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