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成功治疗一例罕见的由软组织(臀肌)脓肿引起的内源性眼内炎。

Successful management of a rare case of endogenous endophthalmitis from soft tissue (gluteal) abscess.

作者信息

Chen Natalie, Chalam K V

机构信息

Department of Ophthalmology, Loma Linda University School of Medicine, Loma Linda, CA, USA.

出版信息

J Surg Case Rep. 2022 Sep 19;2022(9):rjac412. doi: 10.1093/jscr/rjac412. eCollection 2022 Sep.

Abstract

Endophthalmitis, an ophthalmic emergency carries poor visual prognosis without prompt diagnosis and treatment. Endophthalmitis is often exogenous and rarely endogenous. In this report, we describe a rare case of bacterial endogenous endophthalmitis in an immunocompetent 51-year-old patient due to methicillin-resistant staphylococcus aureus septicemia from a gluteal abscess. Ultrasonography confirmed endogenous endophthalmitis. The patient was treated with immediate intravitreal antibiotic injections, prolonged intravenous antibiotics in association with pars plana vitrectomy, retinal detachment repair and vitreous debris removal. Successful treatment was confirmed with negative blood cultures and a clear vitreous on b-scan ultrasound and fundus photography with improvement of his visual acuity. This case highlights the importance of consideration of rare infectious foci as etiology and prompts treatment for successful resolution of endogenous endophthalmitis.

摘要

眼内炎是一种眼科急症,若不及时诊断和治疗,视力预后较差。眼内炎通常为外源性,很少是内源性的。在本报告中,我们描述了一例罕见的细菌性内源性眼内炎病例,患者为一名51岁免疫功能正常的男性,因臀肌脓肿导致耐甲氧西林金黄色葡萄球菌败血症引发眼内炎。超声检查确诊为内源性眼内炎。患者接受了立即玻璃体腔内注射抗生素、延长静脉使用抗生素并联合玻璃体切割术、视网膜脱离修复术及玻璃体碎屑清除术。血培养转阴、B超检查玻璃体清晰、眼底照相显示玻璃体清晰且视力提高,证实治疗成功。该病例强调了将罕见感染灶视为病因并及时治疗以成功治愈内源性眼内炎的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4291/9487197/33dd8fe06233/rjac412f1.jpg

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