Bilateral endophthalmitis complicated with subretinal abscess
Purpose
To report a case of bilateral endophthalmitis and complicated with subretinal abscess.
Methods
Case report and literature review
Results
This 45-year-old man without history of systemic disease had bilateral blurred vision since 3-4 days ago. He visited local clinic and bilateral uveitis was told and treated with topical prednisolone. He first had diarrhea symptom one week ago. Ocular exam showed visual acuity 0.2 for the right eye and light sense positive for the left eye. Hypopyon and vitreous opacity was noted for both eyes. Systemic work-up showed leucocytosis and liver abscess. Blood culture showed Klebsiella pneumonia. Bilateral endophthalmitis was diagnosed. He started to have fever and acute toxic symptoms after hospitalization. Frequent intravitreal injection of vancomycin and ceftazidime was applied to both eyes. Despite frequent treatment, rapid progression was noted. Corneal melting and rupture of left eye was noted and evisceration of left eye was performed. Vitrectomy of the right eye was was arranged. During first vitrectomy, subretinal abscess was noted. The recovery at first week after first vitrectomy was stable. However, progression was noted later. He had subcutanenous abscess at his right arm treated with drainage surgery and systemic antibiotics. Second vitrectomy was arranged. During operation, a new inferior temporal subretinal abscess was noted with macula involvement was noted. Core vitrectomy to decrease vitreous opacity and intravitreal injection of antibiotics and silicone oil tamponade was arranged. He gradually recovered.
Conclusion
Endophthalmitis needs to be ruled out first when seeing a bilateral uveitis. Literature showed no standard treatment for subretinal abscess.
Conflict of interest
No
Authors 1
Last name
WU
Initials of first name(s)
CH
Department
Chang Gung Memorial Hospital Keelung Branch
City
Keelung
Country
Taiwan
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