Hyperacute unilateral gonococcal endophthalmitis in an HIV-infected man without genital infection.
OBJECTIVE
To demonstrate the necessity of obtaining an accurate history from patients presenting abnormal evolution of ophthalmologic diseases.


METHODS
A 42-year-old patient, denying any previous ocular or systemic morbidity, presented with an unusual severe and hyperacute gonococcal endophthalmitis with corneal abscess but no concurrent genitourinary infection. Only after a further interview did the patient reveal his human immunodeficiency virus status and a previous diagnosis of acquired immunodeficiency syndrome.


RESULTS
Adequate topical and intravenous antibiotic treatment and surgery led to salvage of the eye.


CONCLUSIONS
An accurate history should be obtained by patients with an abnormal course of an ophthalmologic disease, focusing on immunologic deficiencies that can cause extremely serious ophthalmologic complications with ensuing risk of visual impairment or ocular loss (bulbar enucleation).
Faggian
F
F
Infectious Diseases Unit, Ospedale Civile Maggiore, Verona, Italy. ffaggian@hotmail.com
Azzini
A
A
Lanzafame
M
M
Bonora
A
A
Zorzi
A
A
Concia
E
E
Vento
S
S
D000038:Abscess / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery; D000208:Acute Disease; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002443:Ceftriaxone / Q000627:therapeutic use; D003316:Corneal Diseases / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery; D004359:Drug Therapy, Combination; D009877:Endophthalmitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D005832:Genital Diseases, Male / Q000382:microbiology; D006069:Gonorrhea / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification*; D009428:Netilmicin / Q000627:therapeutic use; D015242:Ofloxacin / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D009428:Netilmicin; D002443:Ceftriaxone; D015242:Ofloxacin