Endogenous aeromonas hydrophila endophthalmitis in an immunocompromised patient

Abstract

Purpose: To report a case of endogenous endophthalmitis due to Aeromonas hydrophila in a patient with distal common bile duct carcinoma and biliary sepsis.

Methods: A 72-year-old woman with distal common bile duct carcinoma, obstructive jaundice, diabetes mellitus, and hypertension had a 1-day history of blurred vision, redness, and eye discharges in the right eye. An ophthalmic examination showed no light perception vision, increased intraocular pressure, severe corneal edema, severe anterior chamber reaction, exudative membranes on the anterior lens surface, and severe vitreal reaction. There was no ocular history of trauma, infection, or surgery in either eye.

Results: Under the impression of endogenous bacterial endophthalmitis, immediate intraocular cultures and intravitreal antibiotic injections were performed, but the anterior chamber reaction, and the ultrasonogram findings were deteriorated. Evisceration was undertaken because of extrusion of the intraocular contents, and Aeromonas hydrophila was isolated by intraocular culture.

Conclusions: Endogenous endophthalmitis due to Aeromonas hydrophila is rare, but has a rapid clinical course and a poor prognosis, despite of prompt diagnosis and management.

Fig. 1

A. Slit-lamp photograph at initial presentation: Severe corneal edema, hyphema, exudative membranes on anterior lens surface, and mid-dilated pupil. B. B-scan ultrasonograph at initial presentation: Moderate vitreous opacities.

Fig. 2

A. Slit-lamp photograph on the day 2 after intravitreal injections: Totally opaque cornea and inferior protrusion of the eyeball. B. B-scan ultrasonograph on the day 2 after intravitreal injections: Increased and condensed vitreous opacities.

Fig. 3

A. Slit-lamp photograph on the day 6 after intravitreal injections: Perforation of the eyeball. B. Computed tomograph on the day 6 after intravitreal injections: Contracted right eyeball with internal increased densities.