Endogenous endophthalmitis secondary to perirenal abscess

Abstract

Introduction: Endogenous Endophthalmitis is a rare ocular infection but with poor visual prognosis for most patients. Its most frequent etiology is Klebsiella spp., associated with hepatic abscesses and less frequently with perirenal abscesses.

Case presentation: We present a 61-year-old woman with a history of poorly controlled diabetes mellitus 2 that consulted several times for acute pyelonephritis with torpid evolution, associated with endogenous endophthalmitis in her right eye that required evisceration.

Conclusion: Adequate management of acute pyelonephritis can avoid local or distant complications, such as endogenous endophthalmitis, an infection with poor visual prognosis that requires high clinical suspicion for timely management with better visual outcomes and lower morbimortality.

Keywords: acute pyelonephritis; endogenous endophthalmitis; perirenal abscess.

Fig. 1

(a) Clinical appearance on arrival at the emergency department, with ciliary hyperemia, and media opacity due to inflammation in both anterior and posterior chambers. (b) Ocular ultrasound mode B right eye, normal eyeball, vitreous cavity with hyperechogenic content and thickened retinochoroidal complex consistent with endophthalmitis.

Fig. 2

(a) Pre‐operative CT, coronal section with extensive left emphysematous perinephric abscess. (b) Postoperative CT, there is a notorious reduction of the emphysematous perinephric abscess, no alteration in the renal parenchyma, without evidence of recurrence.