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Metastatic Serratia marcescens endophthalmitis
C de Courten1, P Sancho, D BenEzra
1Department of Ophthalmology, Hadassah University Hospital, Jerusalem, Israel.
Journal of Pediatric Ophthalmology and Strabismus
|January 1, 1988
Summary
A ten-day-old infant with Serratia marcescens septicemia developed metastatic endophthalmitis. Despite antibiotics, ocular damage necessitated enucleation, leading to the infant's recovery.
Area of Science:
- Ophthalmology
- Neonatal Medicine
- Infectious Diseases
Background:
- Metastatic endophthalmitis is a rare but severe ocular infection.
- Neonates undergoing abdominal surgery are at risk for sepsis.
Observation:
- A ten-day-old infant developed septicemia caused by Serratia marcescens following a colostomy for an unperforated anus.
- The infant presented with metastatic endophthalmitis, characterized by rapid ocular deterioration despite prompt antibiotic treatment.
Findings:
- Systemic eradication of Serratia marcescens was achieved with specific antibiotics.
- Ocular histopathology revealed extensive choroidal and optic nerve infiltrates with complete retinal architectural destruction.
- Enucleation was performed due to irreversible vision loss and risk of sympathetic ophthalmia.
Implications:
- This case highlights the challenges in managing neonatal metastatic endophthalmitis, even with effective systemic antibiotic therapy.
- Early recognition and aggressive surgical intervention, such as enucleation, may be crucial for patient recovery and preventing sympathetic ophthalmia.
- Serratia marcescens should be considered in the differential diagnosis of neonatal sepsis with ocular complications.