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[Fulminant gas gangrene panophthalmia following perforating scleral injury]
C M Wilk1, K W Ruprecht, G K Lang
1Augenklinik mit Poliklinik, Universität Erlangen-Nürnberg.
Insights
Clostridium perfringens panophthalmitis rapidly developed in a boy after a penetrating eye injury. Prompt enucleation was necessary due to the severe presentation and systemic decline.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Microbiology
Background:
- Penetrating scleral injuries pose a significant risk for severe intraocular infections.
- Clostridium perfringens is an uncommon but highly virulent cause of post-traumatic endophthalmitis.
Observation:
- A 13-year-old male sustained a penetrating scleral injury.
- Rapid onset (within 60 hours) of severe ocular symptoms including pain, edema, proptosis, conjunctival chemosis, purulent exudate, hypopyon with gas bubbles, and amaurosis.
Findings:
- Clinical diagnosis of Clostridium perfringens panophthalmitis.
- Laboratory workup results are detailed.
- Enucleation was required due to the severity of infection and patient's systemic condition.
Implications:
- Highlights the aggressive nature of Clostridium perfringens in post-traumatic panophthalmitis.
- Underscores the importance of prompt recognition and management of severe ocular infections.
- Emphasizes the potential need for globe removal in rapidly progressing, sight-threatening conditions.
Abstract:
A 13-year-old boy developed Clostridium perfringens panophthalmitis due to a penetrating scleral injury. The characteristic symptoms were unusually severe periocular pain, lid edema, decreased motility and protrusion of the eye, severe conjunctival chemosis, pus covering the conjunctiva and cornea, green-brown hypopyon, gas bubbles in the anterior chamber, and amaurosis within 60 hours. In view of the patient's ocular status and impaired general condition enucleation was unavoidable. The results of laboratory workups are reported in addition to the clinical and ophthalmologic findings.