Endogenous pneumococcal endophthalmitis after splenectomy: report of two cases

Two cases of pneumococcal sepsis, meningitis and unilateral endophthalmitis after total splenectomy are described. The first patient, a 9-year-old girl, had severe panuveitis complicated by traction retinal detachment, eventually requiring vitrectomy. Due to large chorioretinal scars the visual recovery was poor. Minor residual neurological signs remained. The second patient, a 39-year-old man, showed endophthalmitis of the right eye. The recovery of the pneumococcal meningitis was complicated by severe neurological impairment. The right eye progressed to phthisis bulbi. The importance of early recognition of postsplenectomy sepsis (PSS) is emphasised since the survival rate is poor and the risk of visual loss high.