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Case Reports
. 2017 Mar;21(3):172-175.
doi: 10.4103/ijccm.IJCCM_375_16.

Metastatic Endogenous Endophthalmitis: A Rare Presentation with Methicillin-resistant Staphylococcus aureus Prostatic Abscess

Mrugank M Bhavsar  1 , T V Devarajan  1 , P Senthur Nembi  2 , Nagarajan Ramakrishnan  3 , Ashwin K Mani  1
Affiliations
Case Reports

Metastatic Endogenous Endophthalmitis: A Rare Presentation with Methicillin-resistant Staphylococcus aureus Prostatic Abscess

Mrugank M Bhavsar et al. Indian J Crit Care Med. 2017 Mar.

Abstract

A 62-year-old male with the previous history of uncontrolled diabetes and hypertension on irregular treatment presented with a history of fever, dysuria, and urinary retention with progressive painful loss of vision over a period of 2 days. His eye examination showed hypopyon, and he was diagnosed to have rapidly progressive endogenous endophthalmitis. He was started on vancomycin and piperacillin-tazobactam empirically. His blood and urine cultures grew methicillin-resistant Staphylococcus aureus (MRSA). Transesophageal echocardiography ruled out infective endocarditis. Intravitreal injection of vancomycin and ceftazidime was given. Vitreous culture also grew MRSA. A workup for possible source revealed multiple prostatic abscesses on the transrectal ultrasound. Antibiotic was changed to daptomycin in view of high vancomycin minimum inhibitory concentration. His vision was improved at the time of discharge.

Keywords: Endophthalmitis; methicillin-resistant Staphylococcus aureus; prostatic abscess; transrectal ultrasound; vancomycin.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Prostate ultrasound showing abscess.
Figure 2
Figure 2
Left eye hypopyon.
Figure 3
Figure 3
Left eye – after completion of treatment.
Figure 4
Figure 4
Fundus examination - subretinal abscess.
Figure 5
Figure 5
Resolving abscess.
See this image and copyright information in PMC

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