A Devastating Ocular Pathogen: β-streptococcus Group G

PURPOSE.To report the clinical findings, treatment, and outcomes of four cases of β-streptococcus Group G (BHS-G) ocular infection. METHODS.The medical and microbiologic records of four cases of BHS-G ocular infection were retrospectively reviewed. RESULTS.Two cases of BHS-G endophthalmitis and two cases of BHS-G keratitis were recorded. Three patients developed fulminant infection within 12 hours of the onset of symptoms. One patient's history was incomplete. One patient developed endophthalmitis from a contaminated donor button; another following cataract surgery. One developed keratitis in a keratoplasty suture tract; and another patient developed a corneal abscess after being struck with a tree branch. The patient with the contaminated donor button developed overwhelming endophthalmitis resulting in no light perception vision, severe pain, and evisceration. The post-operative cataract patient developed a purulent endophthalmitis and is still hypotonus with light perception vision. The second keratitis patient developed a significant suture abscess with marked stromal loss but eventually healed. The traumatic keratitis patient developed a large ulcer with hypopyon and descemetocele but was lost to follow-up. CONCLUSIONS.This is the first report of a series of BHS-G ocular infections. The ocular infections were characterized by rapid onset, extreme inflammation, and—despite in vitro antibiotic sensitivity—a poor or sluggish response to antibiotic therapy.