SHM Converge Scientific Abstract ePoster Gallery-Bacteremia Causing Endogenous Endophthalmitis

Pdf Summary

This document describes endogenous endophthalmitis (EE), a rare intraocular infection caused by bacterial spread through the bloodstream. EE is difficult to diagnose, can occur at any age, and is associated with underlying risk factors; there are no clear guidelines for optimal management.<br /><br />The case involves a 50-year-old man with uncontrolled type 2 diabetes who was hospitalized for pneumonia due to MSSA. He was treated with piperacillin-tazobactam because of a cefazolin allergy. On hospital day 5, he developed redness, pain, itching, and decreased vision in the right eye. Ophthalmology found decreased vision, ocular inflammation, and vitreous haze, consistent with EE. He received intravitreal vancomycin and ceftazidime plus systemic cefazolin. Two days later, the left eye became involved and was treated similarly. Blood cultures were negative and vitreous cultures were not obtained, but his symptoms and vision improved after treatment. At 6-week follow-up, he had no signs of infection and vision returned to 20/20.<br /><br />The discussion notes that EE accounts for only 2–8% of endophthalmitis cases and is usually unilateral; bilateral disease is uncommon. Diagnosis is primarily clinical and supported by blood or vitreous cultures, though negative blood cultures do not exclude EE. Prompt treatment typically includes vitreous aspiration, intravitreal antibiotics, and systemic antibiotics. Early diagnosis and rapid treatment are critical to preserve vision.

Asset Subtitle

Hanish Jain

Meta Tag

Author List Elizabeth Asiago-Reddy, Garima Singh, Hanish Jain

Category Clinical Vignettes

Concept Endogenous Endophthalmitis

Concept Intravitreal Antibiotics

Concept Hematogenous Spread

Concept Vision Loss

Concept Vitreous Haze

Distinguished Non-Finalist

Presenter Organization SUNY Upstate

Presenting Author Hanish Jain

Track Adult

Keywords

endogenous endophthalmitis

intraocular infection

bacterial bloodstream spread

MSSA pneumonia

uncontrolled diabetes

intravitreal vancomycin

ceftazidime

bilateral eye involvement

clinical diagnosis

vision preservation

Endogenous Endophthalmitis

Intravitreal Antibiotics

Hematogenous Spread

Vision Loss

Vitreous Haze