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ESBL E. coli Urosepsis Resulting in Endogenous Panophthalmitis Requiring Evisceration of the Eye in a Diabetic Patient.

Arunachala Murthy T, Rangappa P, Rao S, Rao K - Case Rep Infect Dis (2015)

Bottom Line: A patient admitted with severe ESBL E. coli urosepsis was effectively treated with source control (bilateral DJ stenting for hydroureteronephrosis) and antibiotics.She was found to have features suggestive of bilateral conjunctivitis which progressed to panophthalmitis possibly due to delay in appropriate diagnosis and treatment.Diagnosis requires a very high index of suspicion if eye involvement is noted in a patient with features of bacteraemia and early intervention could possibly produce better outcomes.

View Article: PubMed Central - PubMed

Affiliation: Intensive Care Unit, Columbia Asia Referral Hospital, Yeshwantpur, India.

ABSTRACT
A primary infection in a remote site resulting in vision threatening complications like panophthalmitis in a person who is not immune-compromised is rare. We report a case of endogenous bilateral bacterial endophthalmitis progressing into panophthalmitis in one eye requiring evisceration of that eye. A patient admitted with severe ESBL E. coli urosepsis was effectively treated with source control (bilateral DJ stenting for hydroureteronephrosis) and antibiotics. She was found to have features suggestive of bilateral conjunctivitis which progressed to panophthalmitis possibly due to delay in appropriate diagnosis and treatment. Diagnosis requires a very high index of suspicion if eye involvement is noted in a patient with features of bacteraemia and early intervention could possibly produce better outcomes. To our knowledge, this is the first case of ESBL E. coli urosepsis complicated by microbiologically confirmed panophthalmitis.

No MeSH data available.


Related in: MedlinePlus

Intraoperative findings showed melting cornea and the left eye was eviscerated.
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fig3: Intraoperative findings showed melting cornea and the left eye was eviscerated.

Mentions: She was taken up for left eye evisceration surgery and the necrosed uveal tissue and vitreous humor were scooped out and sent for Gram stain, KOH mount bacterial and fungal culture, and histopathology (Figure 3). Culture of pus from the eviscerated left globe showed Extended Spectrum Beta Lactamase Escherichia coli (ESBL E. coli) which was sensitive to only Amikacin and carbapenems. Histopathology showed features consistent with ESBL E.coli panophthalmitis.


ESBL E. coli Urosepsis Resulting in Endogenous Panophthalmitis Requiring Evisceration of the Eye in a Diabetic Patient.

Arunachala Murthy T, Rangappa P, Rao S, Rao K - Case Rep Infect Dis (2015)

Intraoperative findings showed melting cornea and the left eye was eviscerated.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4553301&req=5

fig3: Intraoperative findings showed melting cornea and the left eye was eviscerated.
Mentions: She was taken up for left eye evisceration surgery and the necrosed uveal tissue and vitreous humor were scooped out and sent for Gram stain, KOH mount bacterial and fungal culture, and histopathology (Figure 3). Culture of pus from the eviscerated left globe showed Extended Spectrum Beta Lactamase Escherichia coli (ESBL E. coli) which was sensitive to only Amikacin and carbapenems. Histopathology showed features consistent with ESBL E.coli panophthalmitis.

Bottom Line: A patient admitted with severe ESBL E. coli urosepsis was effectively treated with source control (bilateral DJ stenting for hydroureteronephrosis) and antibiotics.She was found to have features suggestive of bilateral conjunctivitis which progressed to panophthalmitis possibly due to delay in appropriate diagnosis and treatment.Diagnosis requires a very high index of suspicion if eye involvement is noted in a patient with features of bacteraemia and early intervention could possibly produce better outcomes.

View Article: PubMed Central - PubMed

Affiliation: Intensive Care Unit, Columbia Asia Referral Hospital, Yeshwantpur, India.

ABSTRACT
A primary infection in a remote site resulting in vision threatening complications like panophthalmitis in a person who is not immune-compromised is rare. We report a case of endogenous bilateral bacterial endophthalmitis progressing into panophthalmitis in one eye requiring evisceration of that eye. A patient admitted with severe ESBL E. coli urosepsis was effectively treated with source control (bilateral DJ stenting for hydroureteronephrosis) and antibiotics. She was found to have features suggestive of bilateral conjunctivitis which progressed to panophthalmitis possibly due to delay in appropriate diagnosis and treatment. Diagnosis requires a very high index of suspicion if eye involvement is noted in a patient with features of bacteraemia and early intervention could possibly produce better outcomes. To our knowledge, this is the first case of ESBL E. coli urosepsis complicated by microbiologically confirmed panophthalmitis.

No MeSH data available.


Related in: MedlinePlus