Bilateral Endogenous Endophthalmitis Secondary to Staphylococcus aureus Bacteremia

Bacterial endogenous endophthalmitis is caused by a breach of the blood-ocular barrier by pathogens originating from distant sites. It is a rare cause of endophthalmitis and can lead to devastating outcomes without prompt and adequate treatment. We report the case of a 50-year-old woman with a history of type II diabetes mellitus who experienced an episode of acute myocardial infarction complicated by an acute exacerbation of chronic kidney disease, catheter-related infection, bloodstream infection, bacterial endocarditis, and bilateral endogenous endophthalmitis confirmed by blood culture and bilateral vitreous culture showing growth of methicillin-sensitive Staphylococcus aureus (MSSA). Vision deteriorated to loss of light perception despite aggressive systemic antibiotic therapy and three bilateral intravitreal injections of vancomycin, ceftazidime, and dexamethasone. Due to the severity of her clinical status, vitrectomy was contraindicated. This report presents a rare case of multi-organ infection and damage involving both eyes, which required multidisciplinary follow-up and carefully coordinated management in a patient with a life-threatening condition.