Bilateral Endogenous Endophthalmitis Secondary to Streptococcus pneumoniae: An Uncommon but Devastating Complication

Abstract

Endophthalmitis is an infection of the vitreous and/or aqueous humours, caused by bacteria or fungi, and can be either exogenous (resulting from trauma or intraocular procedures) or endogenous (hematogenous in origin). Although less common than exogenous endophthalmitis, endogenous endophthalmitis can have serious, vision-threatening consequences. Streptococcus pneumoniae is a rare cause of endogenous endophthalmitis and is associated with a poor prognosis. In this report, we present a rare case of pneumococcal endogenous endophthalmitis that led to a devastating outcome despite both medical and surgical interventions. Early systemic treatment and prompt identification of the primary source are crucial and potentially life-saving.

Keywords: endogenous endophthalmitis; hypopyon; pneumococcal; streptococcus pneumoniae; vitrectomy.

Figure 1. B-scan of the right eye revealed (a) vitreous opacities and (b) posterior vitreous detachment

Figure 2. A fundoscopic examination of the left eye revealed that the disc is mildly hyperemic and that the vessels are tortuous; the glistening appearance is caused by the reflection of photographic flash by the oil/retina interface