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Chronic Endophthalmitis Caused by Pseudomonas stutzeri
Saeed T Alshahrani1,2, J Fernando Arevalo3
1Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Case Reports in Ophthalmology
|January 13, 2021
Summary
Recurrent endophthalmitis caused by Pseudomonas stutzeri after intraocular lens implantation was successfully treated by removing the lens. This case highlights the importance of considering P. stutzeri in chronic endophthalmitis diagnoses.
Area of Science:
- Ophthalmology
- Infectious Diseases
Background:
- A patient with a history of myopia correction via clear lens extraction and intraocular lens (IOL) implantation experienced recurrent ocular inflammation.
- Episodes of inflammation occurred every 1-2 months, treated with topical steroids.
Observation:
- The patient presented with sudden vision decrease, ocular redness, and pain.
- Initial treatment for presumed chronic endophthalmitis included pars plana vitrectomy (PPV) and intravitreal antibiotics.
- Vitreous culture identified Pseudomonas stutzeri, sensitive to ceftazidime and gentamicin.
Findings:
- Despite initial treatment, the patient developed recurrent endophthalmitis two weeks later.
- A second PPV with posterior chamber IOL removal led to complete resolution and excellent visual recovery.
Implications:
- Pseudomonas stutzeri can cause chronic and severe endophthalmitis, necessitating its inclusion in differential diagnoses.
- IOL removal may be crucial for resolving persistent P. stutzeri endophthalmitis.
- Strict aseptic techniques are paramount for preventing such infections.
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