Intraocular Inflammation and Palpable Purpura in a Patient with Interstitial Pasteurella multocida Pneumonia

Ocul Immunol Inflamm. 2023 Aug 24:1-5. doi: 10.1080/09273948.2023.2249089. Online ahead of print.

Abstract

Purpose: We describe a case of intraocular inflammation and palpable purpura in a patient with Pasteurella multocida pneumonia.

Methods: A 75-year-old pseudophakic woman with type-2 diabetes and chronic obstructive pulmonary disease complained of lower limb palpable purpura and right vision loss of five-day duration. On admission, right visual acuity was hand motion. Slit-lamp examination disclosed severe conjunctival and ciliary injection, corneal oedema, 3-mm hypopyon with heavy fibrin accumulation and blood clots, and synechiae to the IOL.

Results: Chest computed tomography revealed interstitial pneumonia. Sputum culture yielded P. multocida. Amoxicillin/clavulanic tablets (1 g × 3/daily) and topical and systemic steroids were given. Later on, fluorescein angiography showed multiple choroidal lesions bilaterally. With the above-mentioned therapy, there was full recovery of the skin, lung, and eye lesions.

Conclusion: This report emphasizes that P. multocida infection should be considered in patients with intraocular inflammation, palpable purpura, and interstitial pneumonia. A multidisciplinary approach is necessary for a correct diagnosis and management.

Keywords: Diffuse purpura; Pasteurella multocida; interstitial pneumonia; intraocular inflammation.