title: Orbital cellulitis and endophthalmitis in pseudomonas septicemia.
abstract: We report a case of concurrent orbital cellulitis and endophthalmitis that resulted from endogenous complications of community-acquired Pseudomonas aeruginosa bacteremia in an apparently healthy individual. Pseudomonas pneumonia and extensive focal skin lesions of ecthyma gangrenosum also complicated the condition. The presence of drug-induced neutropenia was a risk factor in this patient. Simultaneous orbital cellulitis and endophthalmitis developed and rapidly progressed. Intravenous, intravitreal, and topical antibiotics were administered along with frequent eye wash with normal saline to dilute copious purulent discharge from a deep subcutaneous abscess of lower eyelid. Because of the exocellular products of Pseudomonas aeruginosa, the sclera and corneal stroma were degraded, resulting in nearly perforated cornea. Tarsoconjunctival flap from the upper eyelid was performed to reconstruct the thinning areas. After the infection was controlled, the patient's ultimate visual acuity was light perception.
authors.affiliation: Department of Ophthalmology, Mahidol University, Siriraj Hospital, Bangkok, Thailand.
authors.forename: Panitee
authors.initials: P
authors.lastname: Luemsamran
authors.forename: Kanograt
authors.initials: K
authors.lastname: Pornpanich
authors.forename: Sumalee
authors.initials: S
authors.lastname: Vangveeravong
authors.forename: Prija
authors.initials: P
authors.lastname: Mekanandha
mesh_terms: D000287:Administration, Topical; D000368:Aged; D000583:Amikacin / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D016470:Bacteremia / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D002442:Ceftazidime / Q000008:administration & dosage; D017714:Community-Acquired Infections / Q000382:microbiology; D004359:Drug Therapy, Combination; D009877:Endophthalmitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007267:Injections; D054517:Orbital Cellulitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D011552:Pseudomonas Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D014822:Vitreous Body
chemical_list: D000900:Anti-Bacterial Agents; D000583:Amikacin; D002442:Ceftazidime