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Endogenous Serratia marcescens panophthalmitis: A case series
Mark P Breazzano1,2, Gowtham Jonna1,3, Niraj R Nathan1,4
1Vanderbilt Eye Institute, Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
American Journal of Ophthalmology Case Reports
|September 12, 2019
Summary
Needle licking is a potential cause of endogenous endophthalmitis in intravenous drug users. Arteriovenous fistula grafts in patients with end-stage renal disease also pose a risk for this rare infection.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Microbiology
Background:
- Endogenous panophthalmitis is a severe intraocular infection.
- Serratia marcescens is an opportunistic pathogen that can cause serious infections.
Observation:
- Two cases of endogenous panophthalmitis caused by Serratia marcescens in intravenous drug users (IVDU) are presented.
- One patient had a history of needle licking prior to injection, a potential novel transmission route.
- The second patient had an infected arteriovenous fistula graft due to end-stage renal disease.
Findings:
- Both patients presented with severe vision loss, hypopyon, and orbital inflammation.
- Cultures confirmed Serratia marcescens infection in the first case and Gram-negative rods in the second.
- Histopathology revealed intense neutrophilic infiltration in the ocular tissues.
Implications:
- Needle licking may be an underrecognized risk factor for endogenous endophthalmitis in IVDU.
- Arteriovenous fistula grafts represent a potential source for Serratia marcescens endophthalmitis in dialysis patients.
- Serratia marcescens endogenous endophthalmitis typically has a poor visual outcome.
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