{
  "abstract": "Purpose: To report a case of Staphylococcus epidermidis endophthalmitis in chronic ocular graft-versus-host disease, refractory to empirical broad-spectrum antibiotics, rapidly identified by metagenomic next-generation sequencing of aqueous humor, and successfully managed with targeted vancomycin without vitrectomy.\n\nMethods: Case report.\n\nResults: A 35-year-old male with chronic oGVHD following allo-HSCT for acute myeloid leukemia developed endophthalmitis after 10 months of progressive disease. Slit-lamp examination revealed central corneal ulceration (4 × 2 mm) with hypopyon (1 mm). B-scan ultrasonography confirmed mild vitreous haze. Conventional microbiological workup of aqueous humor—including Gram stain, potassium hydroxide (KOH) mount, and bacterial/fungal culture—yielded negative results. Aqueous humor mNGS detected 5,543 unique reads of S. epidermidis (genome coverage 12.3%, no co-pathogens), exceeding the clinical significance threshold. Based on this result, therapy was switched to targeted intracameral and periocular vancomycin (10 mg/ml) combined with intravenous vancomycin (0.5 g twice daily). Vancomycin was selected for its reliable Gram-positive coverage, including coagulase-negative staphylococci , referencing the established intravitreal dose of 1 mg/0.1 mL. The infection was controlled without corneal perforation or vitrectomy. AMT was performed for persistent epithelial defects. At 1.5 years follow-up, anatomical preservation was maintained (BCVA 20/400 OD; 20/40 OS).\n\nConclusion: In immunosuppressed oGVHD patients with suspected endophthalmitis, aqueous humor mNGS overcomes the diagnostic limitations of conventional culture and guides a timely switch from empirical antibiotics to targeted therapy, achieving infection control and anatomical preservation without invasive vitrectomy or enucleation.",
  "abstract_shown": true,
  "affiliations": [
    "Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital",
    "Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University",
    "Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology"
  ],
  "article_type": "case report",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
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        0,
        1,
        2
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      "name": "Jingjing Wang"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Junyu Hu"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Xing Liang"
    },
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Fang Yuan"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Lijuan Ren"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Tao Wang"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Zhilin Gao"
    },
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Yajian Duan"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1w71yphbrwav6.bib",
  "cited_by": 0,
  "doi": "10.3389/fimmu.2026.1966692",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13724349/?tool=EBI",
  "id": "1w71yphbrwav6",
  "issns": [
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  "landing_url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1966692/full",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Case Report"
    ],
    [
      "openalex",
      "2731|Ocular Infections and Treatments"
    ]
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  "openalex": "W7222982382",
  "pdf_url": "https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2026.1966692/pdf",
  "pmcid": "PMC13724349",
  "pmid": "42973481",
  "published": "2026-10-19",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/1w71yphbrwav6.ris",
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      "first_seen": "2026-10-30T12:19:17Z",
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  "subjects": [
    {
      "field": "biology",
      "origin": "issn:1664-3224",
      "subfield": "immunology"
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  ],
  "title": "Metagenomic next-generation sequencing of aqueous humor guides targeted therapy for Staphylococcus epidermidis endophthalmitis in chronic ocular graft-versus-host disease: a case report",
  "title_text": "Metagenomic next-generation sequencing of aqueous humor guides targeted therapy for Staphylococcus epidermidis endophthalmitis in chronic ocular graft-versus-host disease: a case report",
  "type": "peer-reviewed",
  "updated_at": "2026-11-06T12:20:52Z",
  "url": "https://research.draconitic.com/paper/1w71yphbrwav6",
  "venue": "Frontiers in Immunology",
  "versions": []
}