al. [7] reported the first case of endogenous P. agglomerans endophthalmitis in the United States. It is a gram-negative aerobic bacillus in the family Enterobacteriaceas. All spe- cies of the genus P. agglomerans can be isolated from fecu- lent materials, plants, and soil; they can be either pathogens or commensals. Within the genus, P. agglomerans is the most commonly isolated species in humans, resulting in soft tissue or bone/joint infections following penetrating trauma by veg- etation [8]. The organism also colonizes cotton and cotton plants and has been shown to cause a benign self-limited fe- ver in intravenous drug abusers who filter drugs through cot- ton before injecting [9,10]. Tissue toxicity associated with gram-negative rods in endophthalmitis is known to generally have a poor outcome [11]. However, in our case the ocular in- fection subsided after vitrectomy, intravitreal injection, and tailored antibiotic treatment. P. agglomerans produces yellow pigments that are typi- cally only noticeable after delayed incubation at room temperature. This distinguishes it from other Enterobacter species. In our case, P. agglomerans was isolated in a vitre- ous culture. Yellow pigment-producing colonies that were 2 mm in size, nonhemolytic, and convex were detected on a blood agar plate (Fig. 3). We believe that our case is the first report of bilateral en- dogenous endophthalmitis caused by P. agglomerans in Korea and the first case reported outside of the United States. Conflict of Interest No potential conflict of interest relevant to this article was reported. SS Seok, et al. Endogenous P. agglomerans Endophthalmitis References 1. Maki DG, Martin WT. Nationwide epidemic of septicemia caused by contaminated infusion products. IV. Growth of microbial pathogens in fluids for intravenous infusions. J Infect Dis 1975;131:267-72. 2. Maki DG, Rhame FS, Mackel DC, Bennett JV. Nationwide epidemic of septicemia caused by contaminated intravenous products. I. Epidemiologic and clinical features. Am J Med 1976;60:471-85. 3. Burchard KW, Barrall DT, Reed M, Slotman GJ. Enterobacter bacteremia in surgical patients. Surgery 1986;100:857-62. 4. Chow JW, Fine MJ, Shlaes DM, et al. Enterobacter bacteremia: clinical features and emergence of antibiotic resistance during therapy. Ann Intern Med 1991;115:585-90. 5. Gallagher PG. Enterobacter bacteremia in pediatric patients. Rev Infect Dis 1990;12:808-12. 6. Jackson TL, Eykyn SJ, Graham EM, Stanford MR. Endogenous bacterial endophthalmitis: a 17-year prospective series and review of 267 reported cases. Surv Ophthalmol 2003;48:403-23. 7. Zeiter JH, Koch DD, Park ED 2nd, Font RL. Endogenous endophthalmitis with lenticular abscess caused by Enterobacter agglomerans (Erwinia species). Ophthalmic Surg 1989;20:9-12. 8. Cruz AT, Cazacu AC, Allen CH. Pantoea agglomerans, a plant pathogen causing human disease. J Clin Microbiol 2007;45: 1989-92. 9. Ferguson R, Feeney C, Chirurgi VA. Enterobacter agglomerans: associated cotton fever. Arch Intern Med 1993;153:2381-2. 10. Harrison DW, Walls RM. “Cotton fever”: a benign febrile syndrome in intravenous drug abusers. J Emerg Med 1990;8: 135-9. 11. Rowsey JJ, Newsom DL, Sexton DJ, Harms WK. Endophthalmitis: current approaches. Ophthalmology 1982;89:1055-66. 251