Mak Chun Yue, Sin Helena Pui-Yee, Chan Vesta Cheuk-Ki, Young Alvin
Department of Ophthalmology and Visual Sciences, Chinese University of Hong Kong, Hong Kong, China.
Department of Ophthalmology & Visual Sciences, Prince of Wales Hospital, Hong Kong, China.
BMJ Case Rep. 2018 Apr 5;2018:bcr-2017-223400. doi: 10.1136/bcr-2017-223400.
A 67-year-old Chinese man presented with acute loss of vision and pain in the left eye with hypopyon in the anterior chamber. The patient was afebrile with no systemic symptoms at presentation. Diagnosis of endogenous endophthalmitis was made with vitreous tap yielding Pars plana vitrectomy was performed twice to clear the infection. Thorough investigations showed no septic foci. Whole body positron emission tomography CT revealed a rectal tumour and biopsy showed adenocarcinoma. He was treated with neoadjuvant chemoirradiation followed by surgery to resect the tumour. Vision in the left eye was hand movement at 12 months postoperatively. This case illustrates endogenous endophthalmitis might be a herald of occult colorectal cancer. Bacteria might gain access into bloodstream via mucosal defect in the tumour.
一名67岁的中国男性因左眼视力急性丧失、疼痛伴前房积脓就诊。患者就诊时无发热及全身症状。通过玻璃体穿刺确诊为内源性眼内炎，进行了两次玻璃体切除术以清除感染。全面检查未发现感染灶。全身正电子发射断层扫描CT显示直肠肿瘤，活检显示为腺癌。他接受了新辅助放化疗，随后进行手术切除肿瘤。术后12个月左眼视力为手动。该病例表明内源性眼内炎可能是隐匿性结直肠癌的先兆。细菌可能通过肿瘤中的黏膜缺损进入血液循环。
