Pseudomonas aeruginosa choroidal abscess in a patient with bronchiectasis.
OBJECTIVE
To report a case of Pseudomonas aeruginosa endophthalmitis with choroidal abscess formation in a patient with bronchiectasis.


METHODS
Case report.


RESULTS
A 75-year-old gentleman with bronchiectasis and P. aeruginosa pneumonia developed painless loss of right eye vision. The patient had previously undergone bronchoscopy to exclude pulmonary neoplasm. Slit-lamp examination revealed intense anterior chamber inflammation with hypopyon and B-scan ophthalmic ultrasound showed a choroidal mass consistent with choroidal abscess. Systemic and topical antibiotics did not prevent further progression of the infection. Patient declined pars plana vitrectomy and opted for enucleation. Polymerase-chain-reaction-based restriction fragment-length polymorphism (PCR-RFLP) of the enucleated eye confirmed P. aeruginosa to be the causative organism.


CONCLUSIONS
P. aeruginosa cannot be completely eradicated by systemic antibiotics, and bronchial colonization of P. aeruginosa can remain a potential source for metastatic infection. P. aeruginosa choroidal abscess, previously reported only in patients with cystic fibrosis, can also occur in bronchiectasis. Physicians should therefore have a high index of suspicion of endogenous endophthalmitis and treat aggressively, especially in patients with subretinal invasion and abscess formation.
Li
Kenneth K W
KK
Eye Institute, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam road, Hong Kong SAR, China. kennethli@rcsed.ac.uk
Tang
Emily W H
EW
Lai
Jimmy S M
JS
Wong
David
D
D000038:Abscess / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D000368:Aged; D001987:Bronchiectasis / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D002829:Choroid / Q000382:microbiology; D015862:Choroid Diseases / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D004269:DNA, Bacterial / Q000032:analysis; D003937:Diagnosis, Differential; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D006801:Humans; D008297:Male; D016133:Polymerase Chain Reaction; D011552:Pseudomonas Infections / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D011550:Pseudomonas aeruginosa / Q000235:genetics / Q000302:isolation & purification*; D014821:Vitrectomy
D004269:DNA, Bacterial