Endogenous Endophthalmitis

This case involves a 44-year-old man with diabetes mellitus and end-stage kidney disease, presenting with fever, blurry vision, and back pain over 2 weeks. Ophthalmologic exam revealed conjunctival injection, corneal edema, and a hypopyon in the left eye, with minimal light perception. Blood and vitreous cultures grew methicillin-sensitive Staphylococcus aureus. Imaging identified paraspinal muscle abscesses and mitral valve endocarditis, indicating hematogenous spread. Diagnosis: bacterial endogenous endophthalmitis. Treatment included intravitreal antimicrobials and an 8-week intravenous cefazolin course. A vitrectomy was deferred due to late presentation. At 2-month follow-up, vision remained poor.

This case involves a 44-year-old man with diabetes mellitus and end-stage kidney disease, presenting with fever, blurry vision, and back pain over 2 weeks. Ophthalmologic exam revealed conjunctival injection, corneal edema, and a hypopyon in the left eye, with minimal light perception. Blood and vitreous cultures grew methicillin-sensitive Staphylococcus aureus. Imaging identified paraspinal muscle abscesses and mitral valve endocarditis, indicating hematogenous spread. Diagnosis: bacterial endogenous endophthalmitis. Treatment included intravitreal antimicrobials and an 8-week intravenous cefazolin course. A vitrectomy was deferred due to late presentation. At 2-month follow-up, vision remained poor.