Acute Post Operative Endophthalmitis with Multidrug-resistant Pseudomonas aeruginosa
Purpose
To report a difficult case of post operative endophthalmitis caused by multidrug-resistant (MDR) Pseudomonas aeruginosa.
Methods
Diagnosis was based on history taking with ophthalmology examination, ultrasonography (USG), laboratory and microbiology testing.
Results
A 65 year woman came with chief complain sudden blurred vision and pain on her right eye, 1 day post cataract surgery. Previously, the patient had experienced improved vision then suddenly became worse. Visual acuity was light perception, conjunctival and pericorneal injection, with corneal thinning and melting were found on ophthalmology examination. Medium-high spike echodence in vitreous was seen in USG examination. Patient was given intravitreal vancomycin-ceftazidime 1mg/2,25mg injection twice, topical levofloxacin and cefazoline fortified, also intravenous ciprofloxacin for 5 days, but there was no improvement. On the fifth day, the vitreous tap culture showed MDR pseudomonas aeruginosa. The therapy was changed to topical vancomycin fortified. Despite all the therapy had been given, the clinical condition remained poor and the visual acuity became no light perception.
Conclusion
Microbiology culture is needed to determine causal microorganism and therapy of acute post operative endophthalmitis. One of the microorganisms is MDR pseudomonas aeruginosa, a fulminant pathogen, with bad prognosis.
Conflict of interest
No
Authors 1
Last name
KUSUMAJATI
Initials of first name(s)
A P
Department
Department of Ophthalmology, Universitas Brawijaya
City
Malang
Country
Indonesia
Authors 2
Last name
Aldina
Initials of first name(s)
R
Department
Department of Ophthalmology, Universitas Brawijaya
City
Malang
Country
Indonesia
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