{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T07:15:17Z","timestamp":1780557317170,"version":"3.54.1"},"reference-count":20,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,7,6]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:p>Endogenous endophthalmitis (EE) is usually encountered in immunocompromised individuals due to various causes and usually follows a systemic septic focus. Here, we describe <jats:italic>Enterococcus casseliflavus-induced<\/jats:italic> EE in an otherwise healthy individual in his early 30s, who had no prior history of trauma, hospitalisation or immune deficiency. The patient presented with acute, unilateral, painful visual loss associated with redness. Despite undergoing vitrectomy and receiving intravitreal injections of vancomycin and ceftazidime, the patient showed limited clinical improvement. Oral linezolid and intravitreal teicoplanin were administered following the antibiotic culture and the sensitivity findings from the vitreous biopsy and aqueous tap. Three weeks following the vitrectomy, the patient\u2019s visual acuity improved to 20\/200, with no signs of disease recurrence. This report highlights the rarity of <jats:italic>E. casseliflavus<\/jats:italic> in causing endophthalmitis in a healthy individual with no systemic septic focus and the efficacy of Teicoplanin against it.<\/jats:p>","DOI":"10.1136\/bcr-2025-266182","type":"journal-article","created":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T08:35:43Z","timestamp":1752654943000},"page":"e266182","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Endogenous endophthalmitis by <i>Enterococcus casseliflavus<\/i> in an apparently healthy individual"],"prefix":"10.1136","volume":"18","author":[{"given":"Priyadarshini","family":"T A","sequence":"first","affiliation":[{"name":"Ophthalmology, Father Muller Medical College, Mangalore, karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6060-7095","authenticated-orcid":false,"given":"Sripathi","family":"Kamath","sequence":"additional","affiliation":[{"name":"Ophthalmology, Father Muller Medical College, Mangalore, karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5454-7683","authenticated-orcid":false,"given":"Anup Kumar","family":"Shetty","sequence":"additional","affiliation":[{"name":"Microbiology, Father Muller Medical College, Mangalore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2622-2397","authenticated-orcid":false,"given":"Madhurima A","family":"Nayak","sequence":"additional","affiliation":[{"name":"Ophthalmology, Father Muller Medical College, Mangalore, karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,7,16]]},"reference":[{"key":"2025082711383382000_18.7.e266182.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2003.11.013"},{"key":"2025082711383382000_18.7.e266182.2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00113-16"},{"key":"2025082711383382000_18.7.e266182.3","doi-asserted-by":"crossref","first-page":"396","DOI":"10.3109\/09273940903216891","article-title":"Culture proven endogenous bacterial endophthalmitis in apparently healthy individuals","volume":"17","author":"Shankar","year":"2009","journal-title":"Ocul Immunol Inflamm"},{"key":"2025082711383382000_18.7.e266182.4","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S398739"},{"key":"2025082711383382000_18.7.e266182.5","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2020-241292","article-title":"Monocular loss of vision following an open tibial fracture: a case of Enterococcus casseliflavus endogenous endophthalmitis","volume":"14","author":"Stephens","year":"2021","journal-title":"BMJ Case Rep"},{"key":"2025082711383382000_18.7.e266182.6","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.016675-0"},{"key":"2025082711383382000_18.7.e266182.7","doi-asserted-by":"crossref","DOI":"10.1016\/j.ajoc.2020.100745","article-title":"Seronegative ocular toxoplasma panuveitis in an immunocompetent patient","volume":"19","author":"Sigle","year":"2020","journal-title":"Am J Ophthalmol Case Rep"},{"key":"2025082711383382000_18.7.e266182.8","doi-asserted-by":"crossref","DOI":"10.3390\/jcm11051183","article-title":"Endogenous Endophthalmitis-The Clinical Significance of the Primary Source of Infection","volume":"11","author":"Gajdzis","year":"2022","journal-title":"J Clin Med"},{"key":"2025082711383382000_18.7.e266182.9","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1038\/eye.2010.145","article-title":"Endogenous endophthalmitis: 10-year experience at a tertiary referral centre","volume":"25","author":"Connell","year":"2011","journal-title":"Eye (Lond)"},{"key":"2025082711383382000_18.7.e266182.10","doi-asserted-by":"crossref","first-page":"834","DOI":"10.4103\/ijo.IJO_1091_19","article-title":"Clinical presentations, microbiology and management outcomes of culture-proven endogenous endophthalmitis in India","volume":"68","author":"Dave","year":"2020","journal-title":"Indian J Ophthalmol"},{"key":"2025082711383382000_18.7.e266182.11","doi-asserted-by":"crossref","first-page":"827","DOI":"10.4103\/ijo.IJO_948_19","article-title":"Clinical profile and outcome of endogenous endophthalmitis at a quaternary referral centre in south India","volume":"68","author":"Pillai","year":"2020","journal-title":"Indian J Ophthalmol"},{"key":"2025082711383382000_18.7.e266182.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2014.06.002"},{"key":"2025082711383382000_18.7.e266182.13","doi-asserted-by":"crossref","unstructured":"Facklam RR , Maria da glorida S , Teixeira LM . History, taxonomy, biochemical characteristics, and antibiotic susceptibility testing of enterococci.2014:1\u201354.","DOI":"10.1128\/9781555817923.ch1"},{"key":"2025082711383382000_18.7.e266182.14","unstructured":"Lebreton F , Willems RJL , Gilmore MS . Enterococcus diversity, origins in nature, and gut colonization. In: Gilmore MS , Clewell DB , Ike Y , eds. Enterococci: from commensals to leading causes of drug resistant infection. Boston: Massachusetts Eye and Ear Infirmary, 2014. 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