Endogenous Endophthalmitis Misdiagnosed as Giant Cell Arteritis.

PURPOSE

Endogenous endophthalmitis is uncommon but potentially dangerous. We present a fatal presentation of endogenous endophthalmitis in the context of steroid use for treatment of giant cell arteritis.

CASE PRESENTATION

An 84-year-old Caucasian female presented to the local emergency room with severe headaches, myalgia and shoulder and calf muscle pain. She was treated for a presumed diagnosis of giant-cell arteritis with corticosteroids and subsequently developed an intense retro-orbital pain in the right eye. Fundus examination revealed a white, vascularized chorioretinal mass at the equator of the eye in the inferotemporal quadrant. Antibiotics were given and a vitrectomy was performed. The culture of the vitreous showed and a diagnosis of disseminated was made.

CONCLUSION AND SIGNIFICANCE

Although uncommon, it is important that ophthalmologists are aware of infections as a differential diagnosis of retinal mass, particularly in immunocompromised patients.