双侧肺炎链球菌性内源性眼内炎。
BILATERAL ENDOGENOUS ENDOPHTHALMITIS FROM STREPTOCOCCUS PNEUMONIAE.
机构信息
Department of Ophthalmology, Henry Ford Hospital, Detroit, Michigan.
出版信息
Retin Cases Brief Rep. 2021 Mar 1;15(2):163-165. doi: 10.1097/ICB.0000000000000760.
PURPOSE
To report a case of bilateral endogenous endophthalmitis from Streptococcus pneumoniae with devastating sequelae.
METHODS
Interventional case report.
RESULTS
A 56-year-old man presented with acute bilateral blurred vision and floaters with fever and hemodynamic instability. Previously, he was diagnosed with acute otitis externa and reported manually extracting several of his own teeth. He underwent a vitreous tap and intravitreal antibiotic injections. Blood and vitreous cultures were positive for S. pneumoniae. The patient later developed life-threatening medical sequelae. His final visual acuity was no light perception in the right eye and 20/25 in the left eye.
CONCLUSION
Diagnosing endogenous endophthalmitis early is essential to initiating a systemic evaluation for potentially life-threatening medical conditions, including sepsis, endocarditis, and osteomyelitis. A high degree of suspicion, expeditious treatment, and interdisciplinary collaboration are essential to maximizing patient outcomes.
目的
报告一例由肺炎链球菌引起的双侧内源性眼内炎，其后果严重。
方法
介入性病例报告。
结果
一名 56 岁男性因双眼急性模糊和漂浮物伴发热和血流动力学不稳定而就诊。此前，他被诊断为急性外耳炎，并自述手动拔出了几颗自己的牙齿。他接受了玻璃体抽取和玻璃体内抗生素注射。血液和玻璃体液培养均为肺炎链球菌阳性。患者后来出现了危及生命的医疗后遗症。他的最终视力右眼无光感，左眼 20/25。
结论
早期诊断内源性眼内炎对于系统评估潜在危及生命的医疗状况至关重要，包括败血症、心内膜炎和骨髓炎。高度怀疑、迅速治疗和跨学科合作对于最大限度地提高患者的治疗效果至关重要。
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