Iris abscess as an unusual presentation of endogenous endophthalmitis in a patient with bacterial endocarditis.
OBJECTIVE
To report the clinical findings and management of a case of endogenous endophthalmitis in a patient with bacterial endocarditis presenting with a septic metastasis to the iris.


METHODS
Observational case report.


METHODS
Review of clinical findings and treatment.


RESULTS
A 37-year-old intravenous drug user hospitalized with bacterial endocarditis secondary to methicillin-sensitive Staphylococcus aureus bacteremia presented with a painful red left eye, hypopyon, and iris abscess. Roth spots were noted in the fundus of the right eye. Aqueous culture was positive for methicillin-sensitive S aureus. The patient was treated with intravitreal, topical, and intravenous antibiotics. The hypopyon and iris abscess resolved within 2 weeks, and the patient achieved a final visual acuity of 20/25 in the left eye.


CONCLUSIONS
Septic metastasis to the iris is a rare occurrence. To our knowledge this is the first reported case of an iris abscess secondary to bacterial endocarditis.
Ramonas
Krista M
KM
Department of Ophthalmology, Mount Sinai School of Medicine, New York, New York 10029, USA. krista.ramonas@mssm.edu
Freilich
Benjamin D
BD
D000038:Abscess / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D000328:Adult; D000867:Anterior Chamber / Q000382:microbiology; D016470:Bacteremia / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D002442:Ceftazidime / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D004697:Endocarditis, Bacterial / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D009877:Endophthalmitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D015818:Eye Infections, Bacterial / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D007499:Iris Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D008297:Male; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D013211:Staphylococcus aureus / Q000302:isolation & purification; D014031:Tobramycin / Q000627:therapeutic use; D014640:Vancomycin / Q000627:therapeutic use
D014640:Vancomycin; D003907:Dexamethasone; D002442:Ceftazidime; D014031:Tobramycin