Acute endophthalmitis caused by Enterococcus faecalis following intravitreal ranibizumab injection

A 58-year-old immunocompetent male developed acute endophthalmitis after intravitreal ranibizumab injection for choroidal neovascular membrane. The preinjection vision in the left eye (LE) was 6/24. One-day postinjection, he presented with pain, redness, and defective vision. The vision in the LE was hand movements at presentation. On examination, the presence of circumcorneal congestion, hypopyon (2 mm), and anterior-chamber reaction was noted. Core vitrectomy was done along with intravitreal injections of vancomycin and ceftazidime. Vitreous biopsy grew Enterococcus faecalis. The isolate was sensitive to vancomycin and moxifloxacin. There was an improvement in vision (6/36) at the final follow-up. We present the case of acute endophthalmitis caused by E. faecalis after intravitreal ranibizumab injection with better visual outcome.