Rhegmatogenous retinal detachment after a lower extremity dog bite: a case report

Area of Science:

• Ophthalmology
• Infectious Diseases
• Critical Care Medicine

Background:

• Endogenous endophthalmitis is typically associated with bacteremia or candidemia.
• The link between endogenous endophthalmitis and rhegmatogenous retinal detachment is not well-established.
• Bacteremia following animal bites can lead to severe systemic complications.

Purpose of the Study:

• To report a unique case of endogenous endophthalmitis and rhegmatogenous retinal detachment secondary to Staphylococcus aureus bacteremia originating from a dog bite.
• To highlight the diagnostic challenges and management of this rare clinical presentation.

Main Methods:

• Case presentation of a 39-year-old male with acute vision loss.
• Clinical workup included identification of oxacillin-resistant Staphylococcus aureus bacteremia.
• Imaging revealed multiple septic emboli, including bilateral pleural effusion, renal abscess, and endogenous endophthalmitis in the right eye.

Main Results:

• The patient developed rhegmatogenous retinal detachment in the affected eye.
• Oxacillin-resistant Staphylococcus aureus bacteremia was confirmed as the source of septic emboli.
• Multiple organ involvement was observed, underscoring the systemic impact of the infection.

Conclusions:

• This case demonstrates a rare manifestation of Staphylococcus aureus bacteremia post-dog bite, involving both endogenous endophthalmitis and rhegmatogenous retinal detachment.
• Early diagnosis and prompt treatment are critical for visual acuity preservation in patients with severe bacteremia and ocular involvement.
• Physicians should consider endogenous endophthalmitis in the differential diagnosis of vision loss in patients with bacteremia, especially after potential inoculation events like animal bites.