Retinal vasculitis and posterior pole "hypopyons" as early signs of acute bacterial endophthalmitis.
OBJECTIVE
To report a case of acute postoperative bacterial endophthalmitis presenting with retinal vasculitis and posterior pole "hypopyons."


METHODS
Observational case report.


METHODS
Observational case report.


RESULTS
In a 73-year-old woman, acute postoperative endophthalmitis presented with retinal vasculitis, diffuse retinal hemorrhages, and several posterior pole "hypopyons" that were collections of yellow-white inflammatory debris. The inflammation was located primarily in the posterior one third of the vitreous, and except for severely impaired visual acuity, the classic signs of acute postoperative endophthalmitis were not present until the next day. An immediate pars plana vitrectomy with intravitreal injection of vancomycin, amikacin, and dexamethasone was performed. Vitreous and aqueous cultures grew coagulase-negative Staphylococcus species. After intravenous and topical therapy for endophthalmitis, the inflammation subsided. Eight weeks after the initial cataract surgery, the best corrected visual acuity of the patient was 20/25.


CONCLUSIONS
Acute postoperative bacterial endophthalmitis may present with atypical clinical signs and inflammation located primarily in the retina and posterior vitreous.
Jeng
B H
BH
Cole Eye Institute, The Cleveland Clinic Foundation,., Cleveland, Ohio 44195, USA.
Kaiser
P K
PK
Lowder
C Y
CY
D000208:Acute Disease; D000368:Aged; D000867:Anterior Chamber; D002387:Cataract Extraction / Q000009:adverse effects*; D009877:Endophthalmitis / Q000150:complications* / Q000382:microbiology*; D005260:Female; D005654:Fundus Oculi; D006801:Humans; D012160:Retina / Q000473:pathology; D012164:Retinal Diseases / Q000209:etiology* / Q000473:pathology; D013203:Staphylococcal Infections; D013492:Suppuration / Q000209:etiology*; D014657:Vasculitis / Q000209:etiology* / Q000473:pathology