Resolution of a choroidal abscess in the setting of endophthalmitis in an immunocompetent host with noninvasive treatment.
OBJECTIVE
The purpose of this article was to report a case of Pseudomonas aeruginosa-related endophthalmitis associated with a choroidal abscess in an immunocompetent patient, with no history of lung disease or surgery that responded to noninvasive treatment and to compare it with other reported cases of P. aeruginosa-related choroidal abscesses.


METHODS
A case report.


METHODS
An 89-year-old immunocompetent man, with a history of hypertension, treated colon cancer, treated prostate cancer, total hip replacement, cataracts, a recent fall, and no history of cystic fibrosis or other lung disease, presents with swelling and congestion of the left eye, conjunctival ulcer, and with later findings of choroidal lesion. The lesions demonstrated pockets of mobile and nonmobile opacities, indicating a choroidal abscess.


RESULTS
Noninvasive treatment with topical and intravenous antibiotics resulted in resolution of the abscess and improvement in visual acuity, while avoiding further retinal damage. Ocular ultrasonography showed that the therapeutic course was able to successfully decrease vitreous opacities, choroidal thickenings, and orbital irregularities. Blood cultures and ocular swabs were positive of P. aeruginosa.


CONCLUSIONS
An elderly immunocompetent patient presenting with Pseudomonas endogenous endophthalmitis-associated choroidal abscess had favorable anatomical and visual outcomes after treatment with only intravenous and topical antibiotics.
Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio.
Naina
N
Gupta
Rishi P
RP
Singh