Adolescent with endogenous endophthalmitis. Case report

Abstract

Introduction: endophthalmitis is defined as a severe intraocular inflammatory reaction that affects the structures of the anterior and posterior segments of the eye, and sometimes also the adjacent ones. Its known causes include infectious ones. Depending on the origin of the germs, these can be endogenous or exogenous.

Objective: to present a case of endogenous endophthalmitis in an adolescent with a history of anemia falciforme.

Case presentation: 14-year-old patient with a anemia falciforme history. He presented a febrile syndrome, muscle aches and arthralgias, interpreted as leptospirosis. Antibiotic treatment was indicated, and after seven days a painful ocular condition appeared, with a sudden decrease in visual acuity in the right eye. Endogenous endophthalmitis, caused by Pseudomonas aeruginosa, was diagnosed without confirming the primary infectious focus. He was treated with intravitreal injections of ceftazidime and vancomycin, fortified eye drops, and parenteral broad-spectrum antibiotics. The infection subsided and, although visual acuity did not improve, the eyeball was preserved. In this case, ischemic signs of a mild vaso-occlusive process towards the periphery of the retina, characteristic of anemia falciforme patients, were observed in the left eye.

Conclusions: the visual prognosis of endogenous endophthalmitis is poor. In the diagnosis it is important to take into account the patient's systemic disease, due to its close relationship with the ocular. The contribution of this work lies in showing the vital importance of correct diagnosis and early treatment to save the eyeball as the first option, and to preserve some useful vision