Journal List > J Korean Ophthalmol Soc > v.54(2) > 1009604

Oh, Lee, and Park: A Case of Endophthalmitis Caused by Shewanella algae after Trauma

Abstract

Purpose

To report a rare case of endophthalmitis caused by Shewanella algae after trauma.

Case summary

A 27-year-old man was referred for trauma caused by a fishing sinker in his right eye. On initial examination at another hospital, his visual acuity was light perception, and intraocular pressure was 50 mm Hg. On slit lamp examination, corneal edema and severe anterior chamber inflammation were observed. Consequently, the next day total pars plana vitrectomy, lensectomy, intravitreal silicone oil injection, and antibiotics injection were performed. After the operation, intraocular pressure was 15 mm Hg and the patient's pain was temporarily decreased. The presence of Shewanella algae in the vitreous culture was determined but antibiotic sensitivity was not proven. The patient received postoperative topical fortified vancomycin, ceftazidime, and tobramycin hourly and underwent intravenous antibiotic therapy. On postoperative day 25, the patient transferred to our hospital and ocular pain presented continuously. Intraocular inflammation was not severe but visual acuity was light perception because of retinal necrosis in the posterior pole. Therefore, the patient received topical fortified antibiotics and intravenous antibiotics therapy. On postoperative month 2, visual acuity was light perception and the patient's right eye progressed to pthisis bulbi.

Conclusions

Here in the first case reported in Korea or other conturies of primary endophthalmitis by Shewanella algae after traumas. Shewanella algae endophthalmitis has a rapid progression and poor visual prognosis in spite of aggressive therapy.

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Figure 1.
Photograph at the first visit. (A) Corneal ring infiltration and anterior chamber cells and flare were seen in the right eye. (B) Corneal edema was seen and inflammatory material was filled in the anterior chamber of the right eye.
jkos-54-365f1.tif
Figure 2.
Photograph at the 14 days after the primary operation. Decreased anterior chamber hazziness and corneal infiltration were seen in the right eye.
jkos-54-365f2.tif
Figure 3.
Photograph at the 25 days after the primary operation. Corneal edema and stromal neovascularization (superior) were seen in the right eye.
jkos-54-365f3.tif
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