METASTATIC PANOPHTHALMITIS FOLLOWING PNEUMOCOCCIC OTITIS MEDIA

Abstract

A boy, aged 4 years, who was anemic, was seen in consultation because of difficulty in maintaining drainage from a suppurative right otitis media of four weeks' duration. The drum had been incised at the end of the second week and again at the end of the third week. At the time that the child was examined, the temperature was 102; the patient was lethargic and irritable. When the drum membrane incision was enlarged there appeared a quantity of thick pus under pressure. At this time it was noted that the left eye was sensitive to light and that the pupil was contracted. No surface lesion could be detected even after staining with fluorescein. A culture taken from the ear revealed the pneumococcus as the offending organism. On the succeeding five days the eye became progressively worse, the cornea became clouded, the globe became inflamed, pus appeared in the anterior