Propionibacterium acnes related endophthalmitis and HFE gene variation

Abstract

Background To report a case of propionibacterium acnes endophthalmitis (PAE) associated with HFE gene mutation. Case presentation A 44-year-old man presented with painless binocular vision loss 5 months after cataract surgery with a previous diagnosis of binocular retinitis pigmentosa. It was initially diagnosed as noninfectious uveitis and treated with methylprednisolone. One month later, he experienced sudden loss of visual acuity and grey patchy opacity surrounding the capsular and intraocular lens implantation in the left eye. The next generation sequencing testshowed the presence of propionibacterium acnes (PA) in his aqueous humor of a very high sequence. The patient improved after anti-infective treatment. Genetic tests showed mutations in EYS gene and HFE gene. Conclusion HFE gene mutation might promote the intraocular growth and reproduction of PA by increasing the concentration of iron ions, leading to PAE in this post-operation patients with normal immune function.