Group B streptococcus (GBS), a gram-positive coccus that occasionally causes neonatal sepsis or invasive infection in the elderly, has been considered a rare cause of endogenous bacterial endophthalmitis (EBE). However, the number of invasive GBS infections is increasing, particularly in elderly patients with underlying conditions such as diabetes mellitus (DM), cardiovascular disease and cancer. We report 6 cases of EBE caused by GBS and review the literature. Retrospective case series and literature review. In the current case series, 6 eyes of 6 patients developed EBE caused by GBS. The average age was 73.5 years. The focus of infection included the urinary tract, cellulitis, arthritis, peritonitis, catheter-associated infection and endocarditis. Four patients had DM. While all 6 strains were sensitive to β-lactams (penicillins and cephems), 4 strains were resistant to levofloxacin (no data for 1 isolate). Each case was treated with the systemic antibiotic to which the individual strain was sensitive. All cases showed poor visual acuity at presentation (decimal visual acuity: less than 0.03). Vitrectomy with intravitreal antibiotics injection was performed in 4 cases. Visual acuity recovered in 4 cases and did not recover in 2 cases, even after vitrectomy. The literature review of 53 eyes of 41 patients revealed that 60% of eyes finally lost all vision, and death occurred in 2 cases. Initial visual acuity of less than counting fingers was associated with a final outcome of lost vision. Of 41 patients, 13 (32%) had DM as an underlying medical condition. The most common extra-ocular infection focus was endocarditis (37%). DM is common in patients with EBE caused by GBS. While the 4 cases in the current report had a relatively good visual acuity outcome, despite poor initial visual acuity, the literature review indicated that EBE caused by GBS is generally a severe condition with a poor prognosis. The current study also indicates the importance of considering the possibility of endocarditis on encountering EBE caused by GBS.

中文翻译：

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B组链球菌引起的内源性眼内炎；病例报告和35个报告病例的审查

B组链球菌（GBS）是一种革兰氏阳性球菌，偶尔会引起老年人的败血症或侵袭性感染，被认为是内源性细菌性眼内炎（EBE）的罕见原因。但是，侵入性GBS感染的数量正在增加，特别是在患有基础疾病（例如糖尿病（DM），心血管疾病和癌症）的老年患者中。我们报告了6例由GBS引起的EBE病例，并复习了文献。回顾性病例系列和文献综述。在当前病例系列中，6例患者中有6眼发展为GBS引起的EBE。平均年龄为73.5岁。感染的重点包括尿路，蜂窝织炎，关节炎，腹膜炎，导管相关感染和心内膜炎。四名患者患有糖尿病。尽管所有6个菌株均对β-内酰胺类（青霉素和头孢烯）敏感，4株对左氧氟沙星有抗药性（1株无数据）。每例均用对单个菌株敏感的全身性抗生素治疗。所有病例表现出较差的视力（小数视力：小于0.03）。玻璃体切除术玻璃体内注射抗生素4例。即使玻璃体切除术后，视力恢复4例，视力恢复2例也未恢复。对41例患者的53只眼睛的文献回顾显示，最终有60％的眼睛失去了视力，其中2例死亡。最初的视力低于手指数与视力丧失的最终结果有关。在41例患者中，有13例（32％）患有DM作为基本疾病。眼外感染最常见的是心内膜炎（37％）。DM在GBS引起的EBE患者中很常见。尽管本报告中的4例患者的视力预后相对较好，尽管最初的视力较差，但文献综述表明，GBS引起的EBE通常是严重的疾病，预后较差。当前的研究还表明考虑由GBS引起的心内膜炎对心内膜炎的可能性的重要性。