Successful treatment of a large choroidal abscess in an immunocompetent child. Treatment of a choroidal abscess.
BACKGROUND
We report the case of a systemically well 4-year-old Aboriginal boy who developed a choroidal abscess after being poked in the left eye with a blunt object.


METHODS
This boy presented with redness and reduced vision in the left eye after a blunt object was poked into his eye by his sibling. He was noted to have a choroidal mass which finally manifested as a choroidal abscess.


RESULTS
His initial visual acuity was 6/60, and dilated fundus examination demonstrated a localised solid-appearing choroidal elevation involving the posterior pole, including the macula. An ultrasound of the eye revealed a choroidal haematoma with an atypical appearance, whose height was 8 mm with a base of 12 mm x 10 mm. The lesion failed to resolve, and eventually resulted in orbital cellulitis that did not respond to intravenous and topical antibiotic treatment. He then went on to achieve complete visual recovery after successful management by transcleral incision, drainage and systemic antibiotic therapy.


CONCLUSIONS
Choroidal abscess has been described in patients who are debilitated, immunocompromised or suffer with systemic disease such as cystic fibrosis or endocarditis. This case represents a unique report of staphylococcal choroidal abscess in a healthy child that completely resolved after transcleral drainage and systemic antibiotics.
Durkin
Shane R
SR
Department of Ophthalmology, Women's and Children's Hospital, Adelaide, South Australia, Australia. shane_durkin@yahoo.com
Muecke
James S
JS
D000038:Abscess / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002675:Child, Preschool; D015862:Choroid Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D003131:Combined Modality Therapy; D004322:Drainage / Q000379:methods; D015818:Eye Infections, Bacterial / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D005131:Eye Injuries / Q000150:complications; D005436:Floxacillin / Q000627:therapeutic use; D006801:Humans; D007121:Immunocompetence; D008297:Male; D013203:Staphylococcal Infections / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D014463:Ultrasonography; D014949:Wounds, Nonpenetrating / Q000150:complications
D000900:Anti-Bacterial Agents; D005436:Floxacillin