Successful management of a rare case of endogenous endophthalmitis from soft tissue (gluteal) abscess

Endophthalmitis, an ophthalmic emergency carries poor visual prognosis without prompt diagnosis and treatment. Endophthalmitis is often exogenous and rarely endogenous. In this report, we describe a rare case of bacterial endogenous endophthalmitis in an immunocompetent 51-year-old patient due to methicillin-resistant staphylococcus aureus septicemia from a gluteal abscess. Ultrasonography confirmed endogenous endophthalmitis. The patient was treated with immediate intravitreal antibiotic injections, prolonged intravenous antibiotics in association with pars plana vitrectomy, retinal detachment repair and vitreous debris removal. Successful treatment was confirmed with negative blood cultures and a clear vitreous on b-scan ultrasound and fundus photography with improvement of his visual acuity. This case highlights the importance of consideration of rare infectious foci as etiology and prompts treatment for successful resolution of endogenous endophthalmitis.