Clostridial endophthalmitis after cornea transplantation--Florida, 2003

Endophthalmitis is a severe condition caused by inflammation of the ocular cavity that often is associated with infection of the internal structures of the eye. The source of infection can include bacteria disseminated through the bloodstream and contamination of the cornea at the time of ocular surgery or trauma. Complications include rapid, reversible vision loss that can progress quickly to panophthalmitis, requiring surgical removal of the eye. Clostridium perfringens, an anaerobic gram-positive bacillus found in soil and bowel flora, is an infrequent cause of endophthalmitis. Although the majority of cases are caused by penetrating injury with soil-contaminated foreign bodies, C. perfringens endophthalmitis has been reported in patients after cataract surgery. This report describes two cases of C. perfringens endophthalmitis that occurred within 24 hours after transplant of contaminated corneas. These cases demonstrate the potential for transmission of Clostridium infection from donor to recipient. Clinicians should be aware of potential infection risks associated with transplantation of corneal tissues and report any infections to the appropriate eye bank.