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Cytomegalovirus Uveitis with Hypopyon Mimicking Bacterial Endophthalmitis.

Yoshida A, Obata H, Kawashima H - Case Rep Ophthalmol Med (2015)

Bottom Line: She was immune-competent and the data indicated neither systemic infections nor diseases.After that, hypopyon in the anterior chamber and the opacity of vitreous body of the left eye were improved, and the BCVA of the left eye was 20/200 one year after the first visit.Therefore, it can be easily misdiagnosed as bacterial endophthalmitis.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Jichi Medical University, 3311-1 Yakushiji, Tochigi, Shimotsuke 329-0498, Japan.

ABSTRACT
We report an 83-year-old immune-competent female with unilateral endophthalmitis extraordinarily caused by cytomegalovirus (CMV). Since she was suspected of suffering possible bacterial endophthalmitis, she was referred to our hospital. At the first visit, hypopyon in the anterior chamber and the opacity of vitreous body were observed in the left eye. The best-corrected visual acuity (BCVA) of the left eye was counting fingers and the intraocular pressure (IOP) was 20 mmHg. Bacterial and fungus culture of the aqueous humor revealed no infection. However, the density of corneal endothelial cell was less than the measurable range and CMV was detected by PCR of the aqueous humor. She was immune-competent and the data indicated neither systemic infections nor diseases. Systemic valganciclovir and corticosteroid were administered. After that, hypopyon in the anterior chamber and the opacity of vitreous body of the left eye were improved, and the BCVA of the left eye was 20/200 one year after the first visit. However, the inflammation of the anterior chamber recurred accompanied by elevated IOP after the discontinuance of administering valganciclovir. CMV-induced uveitis accompanied with hypopyon is quite rare. Therefore, it can be easily misdiagnosed as bacterial endophthalmitis.

No MeSH data available.


Related in: MedlinePlus

Clinical course of the left eye during two years after the first visit. Ad: admission, dis: discharge, (▼): recurrence of inflammation of the anterior chamber, (▲): injection of ceftazidime and vancomycin, (◊): eye drops of ceftazidime and vancomycin, IMP: imipenem/cilastatin, PSL: prednisolone, VG: valganciclovir, and ACT: acetazolamide. (—): best-corrected visual acuity (BCVA), (- - -): intraocular pressure (IOP), and CF: visual acuity of counting fingers.
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fig4: Clinical course of the left eye during two years after the first visit. Ad: admission, dis: discharge, (▼): recurrence of inflammation of the anterior chamber, (▲): injection of ceftazidime and vancomycin, (◊): eye drops of ceftazidime and vancomycin, IMP: imipenem/cilastatin, PSL: prednisolone, VG: valganciclovir, and ACT: acetazolamide. (—): best-corrected visual acuity (BCVA), (- - -): intraocular pressure (IOP), and CF: visual acuity of counting fingers.

Mentions: Subsequently, the inflammation of the anterior chamber often recurred accompanied by raised IOP after the discontinuance of administering valganciclovir. Two years after the first visit, due to corneal opacity, the BCVA of the left eye decreased to 20/1000. The clinical course of the left eye (visual acuity, IOP, and treatment) during two years after the first visit is shown in Figure 4. During the observation period, we had performed neither broad range PCR nor multiplex PCR, since we could not get patient's consent.


Cytomegalovirus Uveitis with Hypopyon Mimicking Bacterial Endophthalmitis.

Yoshida A, Obata H, Kawashima H - Case Rep Ophthalmol Med (2015)

Clinical course of the left eye during two years after the first visit. Ad: admission, dis: discharge, (▼): recurrence of inflammation of the anterior chamber, (▲): injection of ceftazidime and vancomycin, (◊): eye drops of ceftazidime and vancomycin, IMP: imipenem/cilastatin, PSL: prednisolone, VG: valganciclovir, and ACT: acetazolamide. (—): best-corrected visual acuity (BCVA), (- - -): intraocular pressure (IOP), and CF: visual acuity of counting fingers.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4442280&req=5

fig4: Clinical course of the left eye during two years after the first visit. Ad: admission, dis: discharge, (▼): recurrence of inflammation of the anterior chamber, (▲): injection of ceftazidime and vancomycin, (◊): eye drops of ceftazidime and vancomycin, IMP: imipenem/cilastatin, PSL: prednisolone, VG: valganciclovir, and ACT: acetazolamide. (—): best-corrected visual acuity (BCVA), (- - -): intraocular pressure (IOP), and CF: visual acuity of counting fingers.
Mentions: Subsequently, the inflammation of the anterior chamber often recurred accompanied by raised IOP after the discontinuance of administering valganciclovir. Two years after the first visit, due to corneal opacity, the BCVA of the left eye decreased to 20/1000. The clinical course of the left eye (visual acuity, IOP, and treatment) during two years after the first visit is shown in Figure 4. During the observation period, we had performed neither broad range PCR nor multiplex PCR, since we could not get patient's consent.

Bottom Line: She was immune-competent and the data indicated neither systemic infections nor diseases.After that, hypopyon in the anterior chamber and the opacity of vitreous body of the left eye were improved, and the BCVA of the left eye was 20/200 one year after the first visit.Therefore, it can be easily misdiagnosed as bacterial endophthalmitis.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Jichi Medical University, 3311-1 Yakushiji, Tochigi, Shimotsuke 329-0498, Japan.

ABSTRACT
We report an 83-year-old immune-competent female with unilateral endophthalmitis extraordinarily caused by cytomegalovirus (CMV). Since she was suspected of suffering possible bacterial endophthalmitis, she was referred to our hospital. At the first visit, hypopyon in the anterior chamber and the opacity of vitreous body were observed in the left eye. The best-corrected visual acuity (BCVA) of the left eye was counting fingers and the intraocular pressure (IOP) was 20 mmHg. Bacterial and fungus culture of the aqueous humor revealed no infection. However, the density of corneal endothelial cell was less than the measurable range and CMV was detected by PCR of the aqueous humor. She was immune-competent and the data indicated neither systemic infections nor diseases. Systemic valganciclovir and corticosteroid were administered. After that, hypopyon in the anterior chamber and the opacity of vitreous body of the left eye were improved, and the BCVA of the left eye was 20/200 one year after the first visit. However, the inflammation of the anterior chamber recurred accompanied by elevated IOP after the discontinuance of administering valganciclovir. CMV-induced uveitis accompanied with hypopyon is quite rare. Therefore, it can be easily misdiagnosed as bacterial endophthalmitis.

No MeSH data available.


Related in: MedlinePlus