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Postoperative Morganella morganii endophthalmitis associated with subclinical urinary tract infection
Gina Tsanaktsidis1, Smita A Agarwal, Anthony J Maloof
1Western Sydney Eye Hospital, Wentworthville, New South Wales 2145, Australia.
Abstract:
We report a case of Morganella morganii acute endophthalmitis following clear corneal phacoemulsification cataract surgery in which a coincident asymptomatic chronic urinary tract infection was detected postoperatively. Morganella morganii is a gram-negative bacillus that inhabits the gastrointestinal tract and is part of the normal fecal flora. It is an opportunistic pathogen usually encountered in postoperative and nosocomial settings, causing urinary tract and wound infections. Chronic urinary tract infection may be a risk factor for postoperative endophthalmitis. A dipstick urinalysis before elective cataract surgery in elderly patients with a history of recurrent urinary tract infections may be considered.
Insights
A case of Morganella morganii acute endophthalmitis after cataract surgery was linked to a concurrent chronic urinary tract infection. Screening elderly patients with a history of UTIs before surgery may prevent such complications.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Microbiology
Background:
- Cataract surgery, specifically phacoemulsification, is a common procedure.
- Endophthalmitis is a serious intraocular infection that can lead to vision loss.
- Morganella morganii is an opportunistic gram-negative bacterium often associated with healthcare-associated infections.
Observation:
- A patient developed acute endophthalmitis following clear corneal phacoemulsification cataract surgery.
- Postoperatively, a coincident asymptomatic chronic urinary tract infection (UTI) caused by Morganella morganii was identified.
Findings:
- Morganella morganii, a common gut bacterium, can cause opportunistic infections.
- The study suggests a potential link between chronic UTIs and the development of postoperative endophthalmitis.
- Asymptomatic chronic UTIs may serve as a hidden reservoir for pathogens causing severe postoperative complications.
Implications:
- Routine dipstick urinalysis before elective cataract surgery in elderly patients with a history of recurrent UTIs could be beneficial.
- Early detection and management of asymptomatic UTIs may help prevent sight-threatening complications like endophthalmitis.
- This case highlights the importance of considering non-ocular sources of infection in postoperative endophthalmitis.