A Case Report of Endogenous Endophthalmitis Caused by Non-O1/Non-O139 Vibrio Cholerae

Abstract

Purpose: To report a case of endogenous endophthalmitis caused by non-O1/non-O139 Vibrio cholerae. Methods: Case report. Results: A 60-year-old female suffered from a fever, abdominal pain, hypovolemic shock and respiratory failure. One day later, there was erythematous swelling change of her left eyelids. The initial slit-lamp and fundus examinations showed prominent chemosis, conjunctival congestion, subconjunctival hemorrhage, moderate cellular reaction of anterior chamber, and vitreous opacity of the left eye. Endogenous endophthalmitis of the left eye was impressed. The culture from both blood and vitreous tapping fluid revealed non-O1/non-O139 Vibrio cholerae. The patient was treated with the systemic antibiotics of rocephine and cefotaxime, intravitreal injection of 2 mg/0.1 ml ceftazidime combined with 1 mg/0.1 ml vancomycin, and topical eyedrops of 5% ceftazidime. The active ocular infection subsided after 2 weeks of ocular treatment. However, the patient died of pneumonia 2 weeks after the ocular infection subsided. Conclusions: Endogenous endophthalmitis caused by non-O1/non-O139 Vibrio cholerae is uncommon and can occur in patients with liver cirrhosis, hematological malignancices, or immunocompromised disease; even if they are not exposed to dirty seawater or ingestion of raw seafood. Treatment should include systemic, intravitreal injections, and topical eyedrops of antibiotics. Due to a high mortality rate and rapidly progressive ocular infection, early diagnosis and prompt treatment are recommended.