Infective endophthalmitis due to Group G Streptococcal infection in a patient with metastatic ovarian carcinoma.

A woman with stage IV metastatic papillary serous ovarian cancer presented with fever, altered mental status, difficulty with vision and right knee pain. On physical examination, she had pain on palpation and with flexion and extension of the left knee and bilateral purulent, bilateral conjunctivitis. Vitreal ultrasound revealed dense opacities within the posterior vitreous detachment bilaterally. Aspiration of both the left knee and vitreous fluid from the left eye revealed Group G Streptococcus (GGS). Later blood cultures also revealed GGS, susceptible to both vancomycin and cephalosporins. She was started on broad-spectrum antibiotics. The patient was diagnosed with bilateral GGS endophthalmitis and was treated with vitreous injections of vancomycin and ceftazidime. The patient improved significantly after antibiotic treatment though vision was not restored. Given the loss of vision and recurrent metastatic ovarian cancer, she opted to pursue palliative care and passed away within the year.