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.
Eye Institute, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam road, Hong Kong SAR, China. kennethli@rcsed.ac.uk
Kenneth K W
KK
Li
Emily W H
EW
Tang
Jimmy S M
JS
Lai
David
D
Wong
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