Piperacillin/Tazobactam-Induced Bilateral Optic Disc Edema With Serous Retinal Fluid in a Young Female With Pelvic...

The typical visual symptoms of optic disc edema are transient visual obscurations due to fluctuations of the optic nerve head blood perfusion. If it remains untreated, it can cause damage and significant vision loss. Piperacillin/tazobactam (PIP/TAZ) exerts broad activity against most gram-positive and gram-negative aerobic and anaerobic bacteria, including many pathogens producing beta-lactamases. It is administered for the treatment of moderate-to-severe bacterial infections. Ocular adverse reactions after the administration of PIP/TAZ have been rarely reported.

We report a case of a 32-year-old woman, who developed pelvic abscess and sepsis, as a complication of caesarean section. She experienced bilateral optic disc edema with associated intraretinal and subretinal fluid during PIP/TAZ therapy. PIP/TAZ was discontinued the fourth day of its administration and was substituted with ertapenem. Progressive resolution of optic disc edema in both eyes, with complete normalization of the fundus and retinal nerve fiber layer thickness, was observed 2 months after drug discontinuation. However, persistent bilateral discontinuity of the foveal ellipsoid zone remained.

Bilateral optic disc edema with serous retinal fluid after PIP/TAZ therapy is very rare. Prompt discontinuation of the medication and ophthalmic evaluation should be immediately considered when visual symptoms arise. Further pharmacovigilance reporting is warranted to clarify the rarity of this adverse effect after PIP/TAZ administration.