Susanna Fernanda N, Bastian Julia C, de Sá Carricondo Maria Fernanda A, Santos Parra Luiza S
Ophthalmology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, BRA.
Cureus. 2024 Nov 3;16(11):e72937. doi: 10.7759/cureus.72937. eCollection 2024 Nov.
Bacterial endogenous endophthalmitis is caused by a breach of the blood-ocular barrier by pathogens originating from distant sites. It is a rare cause of endophthalmitis and can lead to devastating outcomes without prompt and adequate treatment. We report the case of a 50-year-old woman with a history of type II diabetes mellitus who experienced an episode of acute myocardial infarction complicated by an acute exacerbation of chronic kidney disease, catheter-related infection, bloodstream infection, bacterial endocarditis, and bilateral endogenous endophthalmitis confirmed by blood culture and bilateral vitreous culture showing growth of methicillin-sensitive (MSSA). Vision deteriorated to loss of light perception despite aggressive systemic antibiotic therapy and three bilateral intravitreal injections of vancomycin, ceftazidime, and dexamethasone. Due to the severity of her clinical status, vitrectomy was contraindicated. This report presents a rare case of multi-organ infection and damage involving both eyes, which required multidisciplinary follow-up and carefully coordinated management in a patient with a life-threatening condition.
细菌性内源性眼内炎是由远处部位的病原体破坏血眼屏障所致。它是眼内炎的一种罕见病因，若不及时进行充分治疗，可导致严重后果。我们报告一例50岁女性病例，该患者有II型糖尿病病史，曾经历急性心肌梗死，并发慢性肾脏病急性加重、导管相关感染、血流感染、细菌性心内膜炎以及经血培养和双侧玻璃体培养证实的双侧内源性眼内炎，培养结果显示有甲氧西林敏感金黄色葡萄球菌（MSSA）生长。尽管积极进行了全身抗生素治疗，并双侧玻璃体腔注射了三次万古霉素、头孢他啶和地塞米松，但视力仍恶化为光感丧失。由于其临床状况严重，玻璃体切除术为禁忌。本报告展示了一例罕见的多器官感染及双眼损害病例，对于一名处于危及生命状况的患者，需要多学科随访及精心协调的管理。
