Abstract
Endogenous endophthalmitis is an intraocular infection that results from hematogenous spread of organisms from a distant source of infection. Facial cellulitis is rarely reported as a focus of infection. We report a case of 51-year-old unconscious woman presenting with fever, facial swelling, and decreased visual acuity secondary to facial cellulitis, endogenous endophthalmitis and end-stage renal disease(ESRD). Generally systemic antibiotics in endophthalmitis have low efficacy because of the blood-ocular barrier. The management of endophthalmitis begins with intravitreal antibiotic injections and if the response is not favorable to do a vitrectomy. Twelve hours after the intravitreal antibiotic injection, vitrectomy was considered because of worsening of the vitreal cloudiness. However, the patient's general medical condition precluded vitrectomy. We experienced successful treatment with intravitreal antibiotic injection and continuous intravenous antibiotic administration because of the breakdown of the blood-ocular barrier due to ocular inflammation, especially in the setting of systemic vascular and fluid homeostatic changes.
Highlights
We report a case of 51-year-old unconscious woman presenting with fever, facial swelling, and decreased visual acuity secondary to facial cellulitis, endogenous endophthalmitis and end-stage renal disease (ESRD)
Endogenous endophthalmitis is an intraocular infection that results from hematogenous spread of organisms from a distant source of infection, such as a liver abscess or endocarditis [1,2]
Most endogenous endophthalmitis develops from pneumonia, hepatobiliary disease, myocarditis, or meningitis [3]
Summary
Endogenous endophthalmitis is an intraocular infection that results from hematogenous spread of organisms from a distant source of infection, such as a liver abscess or endocarditis [1,2]. According to a recent review, approximately 2% ~ 6% of endophthalmitis cases are caused by endogenous infection [3]. Endogenous endophthalmitis is associated with underlying medical conditions, such as diabetes, cardiac disease, and malignancy, in up to 90% of patients. Orbital and periorbital cellulitis were reported as causes of endogenous endophthalmitis [5,6], but facial cellulitis is rarely reported as a focus of infection leading to endogenous endophthalmitis [7]. We observed a case of endogenous endophthalmitis with facial cellulitis in a patient with end-stage renal disease (ESRD) and achieved improvement with bilateral intravitreal (vancomycin, ceftazidime) and intravenous antibiotics (vancomycin, meropenem)
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
