Endogenous endophthalmitis associated to St. agalactiae

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Presentation transcript:

Endogenous endophthalmitis associated to St. agalactiae Rafael Yuste Ballesta Mercedes Hernández Martínez José María Marín Sánchez Marcos Ruiz Sánchez HCUVA Murcia

Case report Complicated with retroperitoneal hemorrhage Bedridden 72-year-old man Personal History 1- Rheumatic fever 2- Complicated valve exchange in 2012 Current illness Diagnosis: sepsis and endocarthitis by St. agalactiae Treatment: Intravenous Ceftriaxone 2 g/day Complicated with retroperitoneal hemorrhage Derived to our hospital for lumbar artery clamping

Ophthalmology consultation required Persistent visual loss and painfull red RE since 1 week Multiple catheters and Blood culture: A. baumanii (+) RE vitritis LE normal RE VA 0.25 vitreous haze +3 Endogenous endophthalmitis Diagnostic and therapeutic PPV in RE

Diagnostic and Therapeutic PPV in RE - PPV 23G - Intravitreal treatment Voriconazol 100 μg / 0.1 ml Ceftazidime2,25 mg /0,1 mL Vancomicine 1 mg / 0,1mL Vitreous condensation

Some small vitreous peripherical condensations RE 1 day after surgery RE VA 0.16 Vitreo – retinal abscess Some small vitreous peripherical condensations

Negative vitreous cultures!!! 1 week after - surgery Montaje FO RE VA 0.8 Negative vitreous cultures!!!

CONCLUSIONS Endogenous endophthalmitis should be seen as a systemic infection. We decided to agree intravitreal Voriconazol due to a suspected fungal ethiology. PPV accelerates the healing process as happened in our case.