title: Orbital cellulitis, panophthalmitis, and ecthyma gangrenosum in an immunocompromised host with pseudomonas septicemia.
abstract: OBJECTIVE
  To describe a case of Pseudomonas aeruginosa septicemia complicated by orbital cellulitis, panophthalmitis, and ecthyma gangrenosum.
  
  
  METHODS
  Observational case report.
  
  
  METHODS
  An immunosuppressed 62-year-old man developed an unusual skin rash and a painful, swollen right eye with decreased vision. He had myelodysplastic syndrome and P. aeruginosa septicemia. The skin rash manifested as ecthyma gangrenosum. Metastatic orbital cellulitis and panophthalmitis was diagnosed.
  
  
  RESULTS
  Despite intravitreal and topical gentamicin, the patient eventually required enucleation.
  
  
  CONCLUSIONS
  This case represents a rare combination of events: an immunocompromised man developed pneumonia, P. aeruginosa septicemia, and endogenous seeding of the Pseudomonas to the skin, orbit, and eye. Early recognition of endogenous ophthalmic disease is imperative. The prognosis of combined orbital cellulitis and panophthalmitis is poor.
authors.affiliation: Department of Ophthalmology, Princess Alexandra Hospital, Brisbane, Queensland, Australia. lmaccheron@hotmail.com
authors.forename: Luke J
authors.initials: LJ
authors.lastname: Maccheron
authors.forename: Erwin R
authors.initials: ER
authors.lastname: Groeneveld
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Ohlrich
authors.forename: David J
authors.initials: DJ
authors.lastname: Hilford
authors.forename: Peter S
authors.initials: PS
authors.lastname: Beckingsale
mesh_terms: D016470:Bacteremia / Q000150:complications* / Q000175:diagnosis; D002481:Cellulitis / Q000175:diagnosis / Q000209:etiology*; D004473:Ecthyma / Q000175:diagnosis / Q000209:etiology*; D015353:Eye Enucleation; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D009916:Orbital Diseases / Q000175:diagnosis / Q000209:etiology*; D010202:Panophthalmitis / Q000175:diagnosis / Q000209:etiology*; D011552:Pseudomonas Infections / Q000150:complications* / Q000175:diagnosis; D014057:Tomography, X-Ray Computed; D014822:Vitreous Body / Q000382:microbiology