title: Endogenous endophthalmitis with subretinal abscess after dental procedures.
abstract: Endogenous endophthalmitis with subretinal abscess is an extremely uncommon complication following dental procedures. An unsuspected source of infection or misdiagnosis of the condition as iridocyclitis may result in inadequate or delayed treatment leading to severe visual impairment. A high index of suspicion is required for accurate diagnosis and prompt treatment. A 49-year-old man was found to have endophthalmitis in his right eye after treatment of gingival abscess. Ophthalmoscopic examination revealed multiple septic emboli and a 4-disc diameter sized subretinal abscess in his retina. No other infectious origin could be found on systemic work-up. Cultures from blood, urine, aqueous and vitreous were all negative. Pars plana vitrectomy was performed 8 days after the initial presentation because of deterioration of visual acuity to finger counting despite intravitreal and systemic antibiotics administration. Visual acuity recovered to 20/25 one month postoperatively and the retina remained attached during follow-up for 1 year. Ophthalmologists should be aware of the possibility of transient septicemia-induced endophthalmitis and subretinal abscess after dental procedures. Prompt intervention with systemic and intravitreal antibiotics combined with pars plana vitrectomy can achieve successful visual and anatomic outcome.
authors.affiliation: Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Tzu-Hsun
authors.initials: TH
authors.lastname: Tsai
authors.forename: Chang-Hao
authors.initials: CH
authors.lastname: Yang
authors.forename: Chung-May
authors.initials: CM
authors.lastname: Yang
authors.forename: Muh-Shy
authors.initials: MS
authors.lastname: Chen
mesh_terms: D000038:Abscess / Q000209:etiology* / Q000628:therapy; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D009877:Endophthalmitis / Q000209:etiology* / Q000628:therapy; D005882:Gingival Diseases / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019647:Oral Surgical Procedures / Q000009:adverse effects*; D012164:Retinal Diseases / Q000209:etiology* / Q000628:therapy
chemical_list: D000900:Anti-Bacterial Agents