Complexities in diagnosing and treating endophthalmitis in the post stem cell transplant setting

BMJ Case Rep. 2022 Jun 20;15(6):e250552. doi: 10.1136/bcr-2022-250552.

Abstract

Endophthalmitis is a rare but sight-threatening manifestation of systemic infection. Immunosuppression is a well-recognised risk factor for development of endophthalmitis. Determining the aetiology can be complex, particularly in the context of immunosuppression, we present the diagnostic and treatment dilemmas associated with a patient who complains of blurred vision 2 weeks following an allogeneic stem cell transplant for refractory Hodgkin's disease. We demonstrate that in the context of immunosuppression post stem cell transplantation, a broad differential should be maintained until a microbiological diagnosis can be confirmed. In particular, we evaluate how clinical suspicion can diverge from typical fundoscopic findings in the diagnosis of endophthalmitis.

Keywords: Haematology (incl blood transfusion); Infectious diseases; Ophthalmology.

Publication types

  • Case Reports

MeSH terms

  • Endophthalmitis* / diagnosis
  • Endophthalmitis* / drug therapy
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Hodgkin Disease* / complications
  • Hodgkin Disease* / diagnosis
  • Hodgkin Disease* / therapy
  • Humans
  • Immunosuppression Therapy
  • Stem Cell Transplantation / adverse effects