Panophthalmitis Caused by Providencia stuartii: A Rare Opportunistic Ocular Infection

This case report describes a case of Providencia stuartii panophthalmitis, a rare opportunistic ocular infection. A 58-year-old lady with diabetes mellitus presented with painful vision loss in the left eye for one day. Visual acuity was light perception with a relative afferent pupillary defect. Examination showed limitation of extra-ocular muscle movement in all gazes, proptosis, erythematous lid swelling, conjunctival injection, oedematous cornea, and hypopyon with fibrin in the anterior chamber. B-scan showed vitritis, loculations, and scleritis. Vitreous culture revealed P. stuartii. Concurrently,contrast-enhanced computed tomography (CECT) of the orbit demonstrated left eye proptosis, circumferential scleral thickening and enhancement, choroidal enhancement, and fat stranding across both the intraconal and extraconal spaces, highly suggestive of panophthalmitis. She was treated with intravitreal vancomycin and ceftazidime, topical ciprofloxacin and ceftazidime, and systemic ciprofloxacin and meropenem. Due to corneal perforation, evisceration was done. Vitreous, uveal, and conjunctival cultures grew P. stuartii. Chemosis and eye discharge were reduced with topical cefuroxime and chloramphenicol, but with residual necrotic tissue. P. stuartii infection is a rare and serious ocular infection with a poor visual outcome.