Orbital cellulitis and endophthalmitis in pseudomonas septicemia.
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.
Luemsamran
Panitee
P
Department of Ophthalmology, Mahidol University, Siriraj Hospital, Bangkok, Thailand.
Pornpanich
Kanograt
K
Vangveeravong
Sumalee
S
Mekanandha
Prija
P
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
D000900:Anti-Bacterial Agents; D000583:Amikacin; D002442:Ceftazidime