Combined endophthalmitis and orbital cellulitis in patients with corona virus disease (COVID-19)

Mohamed Farouk Sayed Othman Abdelkader,Mostafa A Abu Elela,Ahmed Mohamed Kamal Elshafei,Mahmoud Mamdouh Nassar,Raafat Mohyeldeen Abdelrahman Abdallah

doi:10.1186/s12348-021-00258-y

Mohamed Farouk Sayed Othman Abdelkader, Mostafa A Abu Elela + Show 3 more

Open Access

https://doi.org/10.1186/s12348-021-00258-y

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Abstract

PurposeTo document the presentation of unilateral combined endophthalmitis and orbital cellulitis in patients with COVID-19 infection and study their prognosis.Patients and methodsThis interventional case series study included 9 patients referred to the Ophthalmology Department, Minia University Hospital with unilateral combined endophthalmitis and orbital cellulitis between April 2020 and March 2021. In addition to the COVID-19 work-up, all patients were subjected to full ophthalmological evaluation and managed according to their ophthalmic and systemic disease.ResultsThe patients were 5 females and 4 males. They had clinical, laboratory and imaging findings that confirmed COVID-19 infection. All patients had unilateral endophthalmitis with orbital cellulitis and profound visual loss in the affected eye. Three patients died due to respiratory failure, while 6 patients recovered systemically. The survived patients developed atrophia bulbi in 4 patients and in 2 patients, the globe retained normal size but with complete visual loss.ConclusionCombined endophthalmitis and orbital cellulitis can be one of the early presentations of patients with COVID-19 infection with poor visual prognosis.Trial registrationClinical registration: clinicaltrials.gov identifier: NCT04456556.

Highlights

Corona viruses represent a group of viruses that can cause respiratory infections ranging from common coldlike manifestations to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS)
Abdelkader et al Journal of Ophthalmic Inflammation and Infection (2021) 11:27 patients with COVID-19 with acute unilateral ocular pain, proptosis and visual loss secondary to combined endophthalmitis and orbital cellulitis. Patients and methods This was an interventional case series study which included 9 patients referred to the Ophthalmology Department of Minia University Hospital with visual loss, ocular and orbital inflammation between April 2020 and March 2021
All patients had laboratory findings of hypochromic microcytic anemia with hemoglobin ranged between 5.8–9.2 g/dl, increased total leucocytic count ranged between 12,700–22,300, and relative lymphocytopenia between 7 and 16% and positive polymerase chain reaction (PCR) of nasopharyngeal swabs for COVID-19

Summary

Introduction

Corona viruses represent a group of viruses that can cause respiratory infections ranging from common coldlike manifestations to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). Severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) is the most recently discovered corona virus [1]. It is a novel enveloped, positive single-stranded RNA virus that was originally linked to an outbreak in Wuhan, China [2]. Li Wenliang, a Chinese ophthalmologist, was the first to suspect the presence of Corona virus in his patients. He later died from SARS-COV-2 infection transmitted from an asymptomatic glaucoma patient in his clinic. Al reported a 28 years old male patient with COVID-19 first presented with foreign body sensation and redness of his left eye with unilateral eyelid edema and moderate conjunctival hyperemia [4].

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