Bilateral endogenous endophthalmitis complicated by scleral perforation: an unusual presentation

BMJ Case Rep. 2021 Sep 21;14(9):e244547. doi: 10.1136/bcr-2021-244547.

Abstract

Endogenous endophthalmitis complicated by necrotising scleritis has rarely been reported in the literature. We, hereby, report a case of bilateral scleral perforation with endogenous endophthalmitis in an 87-year-old female patient with diabetes who presented as bilateral orbital cellulitis. Systemic workup ruled out autoimmune aetiology. The culture and sensitivity of exudates exuding from the scleral perforation showed Escherichia coli The Patient was managed conservatively with parenteral and topical antibiotics along with steroid, but the vision could not be salvaged. The report emphasizes on atypical presentation of endogenous endophthalmitis. In old and immunosuppressed individuals presenting with a clinical picture of bilateral orbital cellulitis with profound vision loss, endogenous endophthalmitis should be ruled out.

Keywords: diabetes; pain; retina; urinary tract infections.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use
  • Endophthalmitis* / diagnosis
  • Endophthalmitis* / drug therapy
  • Escherichia coli
  • Female
  • Humans
  • Scleritis* / diagnosis
  • Scleritis* / drug therapy
  • Scleritis* / etiology

Substances

  • Anti-Bacterial Agents