title: Metastatic Endogenous Endophthalmitis: A Rare Presentation with Methicillin-resistantStaphylococcus aureusProstatic Abscess.
abstract: A 62-year-old male with the previous history of uncontrolled diabetes and hypertension on irregular treatment presented with a history of fever, dysuria, and urinary retention with progressive painful loss of vision over a period of 2 days. His eye examination showed hypopyon, and he was diagnosed to have rapidly progressive endogenous endophthalmitis. He was started on vancomycin and piperacillin-tazobactam empirically. His blood and urine cultures grew methicillin-resistantStaphylococcus aureus(MRSA). Transesophageal echocardiography ruled out infective endocarditis. Intravitreal injection of vancomycin and ceftazidime was given. Vitreous culture also grew MRSA. A workup for possible source revealed multiple prostatic abscesses on the transrectal ultrasound. Antibiotic was changed to daptomycin in view of high vancomycin minimum inhibitory concentration. His vision was improved at the time of discharge.
authors.affiliation: Department of Critical Care Medicine, Apollo First Med Hospital, Chennai, Tamil Nadu, India.
authors.forename: Mrugank M
authors.initials: MM
authors.lastname: Bhavsar
authors.affiliation: Department of Critical Care Medicine, Apollo First Med Hospital, Chennai, Tamil Nadu, India.
authors.forename: T V
authors.initials: TV
authors.lastname: Devarajan
authors.affiliation: Department of Infectious Diseases, Apollo First Med Hospital, Chennai, Tamil Nadu, India.
authors.forename: P Senthur
authors.initials: PS
authors.lastname: Nembi
authors.affiliation: Department of Critical Care Medicine, Apollo Hospitals, Chennai, Tamil Nadu, India.
authors.forename: Nagarajan
authors.initials: N
authors.lastname: Ramakrishnan
authors.affiliation: Department of Critical Care Medicine, Apollo First Med Hospital, Chennai, Tamil Nadu, India.
authors.forename: Ashwin K
authors.initials: AK
authors.lastname: Mani
keywords: Endophthalmitis; methicillin-resistant Staphylococcus aureus; prostatic abscess; transrectal ultrasound; vancomycin