title: Bilateral hematogenous Pseudomonas aeruginosa endophthalmitis after lung transplantation.
abstract: Pseudomonas aeruginosa commonly colonizes the airways of patients with cystic fibrosis (CF). However, the occurrence of bacteremia with metastatic infection to the eye causing endogenous endophthalmitis is very rare. In the setting of lung transplantation, the significance of P. aeruginosa bacteremia in patients with CF whose airways are colonized before transplantation is unknown. We report a case of bilateral P. aeruginosa endogenous endophthalmitis in a patient with CF after lung transplant without documented bacteremia. The patient presented with acute eye symptoms in the presence of a left atrial thrombus and the disease followed a rapidly progressive course requiring aggressive medical-surgical treatment. Typically P. aeruginosa endophthalmitis has been associated with a poor visual prognosis. However, with combined medical-surgical management this patient retained useful vision in one eye without having retinal detachment or requiring enucleation. Endogenous endophthalmitis should be considered in the differential diagnosis of ocular complaints in patients with CF after lung transplant.
authors.affiliation: Division of Pulmonary Diseases, Critical Care Medicine and Lung Transplantation, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
authors.forename: S
authors.initials: S
authors.lastname: Dua
authors.forename: W
authors.initials: W
authors.lastname: Chalermskulrat
authors.forename: M B
authors.initials: MB
authors.lastname: Miller
authors.forename: M
authors.initials: M
authors.lastname: Landers
authors.forename: R M
authors.initials: RM
authors.lastname: Aris
mesh_terms: D000328:Adult; D003550:Cystic Fibrosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D004269:DNA, Bacterial / Q000032:analysis; D003937:Diagnosis, Differential; D009877:Endophthalmitis / Q000175:diagnosis* / Q000382:microbiology; D005260:Female; D006801:Humans; D008168:Lung / Q000737:chemistry / Q000000981:diagnostic imaging / Q000382:microbiology; D016040:Lung Transplantation; D011552:Pseudomonas Infections / Q000175:diagnosis* / Q000209:etiology; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D012160:Retina / Q000473:pathology; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014822:Vitreous Body / Q000737:chemistry / Q000000981:diagnostic imaging / Q000382:microbiology
chemical_list: D004269:DNA, Bacterial