The emergence of antibiotic-resistant organisms among severe ocular infections is of grave concern. We describe the first reported case of vancomycin-resistant enterococcal endophthalmitis following ocular trauma, uniquely caused by Enterococcus gallinarum. The organism demonstrated intrinsic resistance to ceftazidime and vancomycin but responded favorably to a combination of intravitreal and intravenous ampicillin, plus intravitreal amikacin. When faced with a multidrug-resistant organism, the ophthalmologist must consider alternative antibiotic strategies.
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