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Aim  To describe the clinical presentations and management outcomes of  Kocuria  endophthalmitis and discuss diagnostic dilemmas    Design  Retrospective interventional comparative case series    Intervention  Eight unilateral cases with culture-proven  Kocuria  endophthalmitis from January 2013 to December 2017 underwent vitrectomy/vitreous biopsy and intravitreal antibiotic with or without additional procedures. The undiluted vitreous was subjected to microbiologic evaluation.    Main outcome measures  The mean age at presentation, etiology, number of interventions, interval between inciting event and presentation, type of intravitreal antibiotic used, and anatomic and functional outcomes were reported. A favorable anatomic outcome was defined as preservation of the globe, absence of hypotony, attached retina, and absence of active inflammation at the last visit.    Results  In the current series, there were five males and three females. The mean age at presentation was 31 ± 17.44 years (median 30 years). The inciting event was open globe injury in five cases and one case each following cataract surgery, microbial keratitis, and endogenous cause. Visual acuity was ≥ 20/400 in one case at presentation and ≥ 20/400 in three cases at the last visit. The species identified by Vitek 2, included  Kocuria kristinae  in three,  K. rosea  in four and  K. varians  in one. Follow-up period was 8.25 ± 8.24 months (median 6.5). Six cases (75%) had complete resolution of infection and inflammation at the last visit. Anatomic success was achieved in 75%.    Conclusions   Kocuria  is a relatively rare cause of endophthalmitis often misdiagnosed as  Staphylococcal  endophthalmitis. Clinical presentation can be variable but favorable antibiotic susceptibility and appropriate timely management can result in acceptable visual and anatomic outcomes.

Clinical presentations, management outcomes, and diagnostic dilemma in Kocuria endophthalmitis