Salmonella associated endogenous endophthalmitis: a case study and review of literature

To report a rare case of bilateral endogenous endophthalmitis caused by Salmonella Paratyphi A in an immunocompetent patient and to review the relevant literature.

Brief report.

A 23-year-old woman presented with acute bilateral vision loss over one day. She had previously received systemic corticosteroids for a presumed Vogt-Koyanagi-Harada syndrome and was administered oral steroids. At presentation, examination revealed conjunctival congestion, Descemet's folds, fibrinous anterior chamber reaction, and hypopyon in the left eye, with obscured; fundus details. B-scan ultrasonography demonstrated a thickened retinochoroidal complex with shallow choroidal detachments and anechoic vitreous cavities. Blood culture grew Salmonella Paratyphi A and vitreous cytology showed abundant monocytes. She received intravitreal vancomycin (1 mg/0.1 ml) and ceftazidime (2.25 mg/0.1 ml), IV ceftriaxone 2 g/day guided by susceptibility, topical prednisolone acetate 1% and atropine 1%, and a tapering course of oral steroids. Following resolution of anterior segment inflammation, she underwent pars plana vitrectomy with lensectomy and silicone oil endotamponade in both eyes. Postoperatively, best-corrected visual acuity improved to 20/250 (OD) and 20/200 (OS).

While Salmonella-associated endogenous endophthalmitis is typically associated with poor visual outcomes, this bilateral Paratyphi A case demonstrates that prompt recognition and aggressive combined medical and surgical management can achieve meaningful visual recovery.