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. 2023 Jul 8;85(8):4137-4141.
doi: 10.1097/MS9.0000000000001051. eCollection 2023 Aug.

Endogenous endophthalmitis in post-COVID-19 patients: a case report

Santosh Chaudhary  1 , Ranju K Sitaula  2 , Pratap Karki  2 , Sagun N Joshi  2
Affiliations

Endogenous endophthalmitis in post-COVID-19 patients: a case report

Santosh Chaudhary et al. Ann Med Surg (Lond). .

Abstract

Ocular involvement in coronavirus disease 2019 (COVID-19) can be due to direct viral invasion or indirectly due to an immunosuppressed state. Prolonged hospitalization also makes them susceptible to various secondary infections. The purpose of this case report is to report two rare cases of endogenous endophthalmitis (EE) in COVID-19 recovered patients.

Case presentation: Two patients who were hospitalized and received treatment for COVID-19 pneumonia with remdesivir and systemic steroids presented with decreased vision. The first case had a severe anterior chamber reaction with a hypopyon and dense exudates in the vitreous. The second case had cells and flare in the anterior chamber and exudates in the vitreous. They were diagnosed with EE and underwent a diagnostic vitreous tap followed by pars plana vitrectomy and intravitreal antibiotic and steroid. The culture of vitreous fluid was negative for any bacteria and fungus in both cases. However, the first case demonstrated Escherichia coli in urine culture. The follow-up visual acuity was no perception of light and only perception of light in the first and second case, respectively.

Clinical discussion: Severe COVID-19 patients who are hospitalized, receive systemic steroid and have associated comorbidities like diabetes mellitus are at high risk of EE.

Conclusion: Delay in diagnosis and appropriate treatment in these patients leads to poor visual outcome.

Keywords: SARS-CoV-2 virus; case study; coronavirus disease 2019; endogenous; endophthalmitides.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Clinical photograph of OD showing (A) circumcorneal congestion with hypopyon (B) cells 4+ and flare 4+ in the anterior chamber (C) Ultrasound B-Scan showing heterogenous opacity in entire vitreous persisting up to 90 dB suggestive of exudate in vitreous cavity.
Figure 2
Figure 2
Clinical photograph of OS showing (A) conjunctival edema with circumcorneal congestion (B) cells 4+ and flare 4+ in the anterior chamber without hypopyon (C) Ultrasound B-Scan of showing heterogenous opacity in mid and posterior vitreous persisting up to 90 dB suggestive of exudate.
See this image and copyright information in PMC

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