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Endogenous pneumococcal endophthalmitis followed by pneumococcal-induced uveitis
Fabio Nessi1, Etienne H Bovey, Yan Guex-Crosier
1Hôpital Ophtalmique Jules Gonin, Lausanne, Suisse.
Klinische Monatsblatter Fur Augenheilkunde
|March 29, 2003
Summary
A rare case of severe bilateral endophthalmitis occurred in a patient with a history of splenectomy. Despite aggressive treatment, vision loss persisted, suggesting a complex immune response post-infection.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Immunology
Background:
- Describes a rare case of fulminant bilateral endophthalmitis in a patient with a prior splenectomy for idiopathic thrombocytopenic purpura.
- Highlights the potential for severe ocular infections in asplenic individuals.
Observation:
- A 40-year-old woman presented with fever, decreased vision, and meningitis following travel.
- Bilateral endophthalmitis was diagnosed, complicated by fibrinoid anterior chamber reaction, cataract, and vitritis.
Findings:
- Despite intensive local and systemic antibiotic and steroid therapy, including intravitreal injections and bilateral vitrectomy, visual acuity remained poor.
- No bacteria were isolated from vitreous cultures, suggesting a potential immune-mediated inflammatory process following infection.
Implications:
- This case underscores the critical role of the spleen in managing encapsulated bacterial infections and preventing severe disseminated disease.
- The complex inflammatory response highlights the need for tailored treatment strategies in immunocompromised patients with endophthalmitis.