Bilateral endophthalmitis as the initial presentation of bacterial meningitis

Korean J Ophthalmol. 2009 Dec;23(4):321-4. doi: 10.3341/kjo.2009.23.4.321. Epub 2009 Dec 4.

Abstract

To report a case of bilateral endophthalmitis as the initial presentation of bacterial meningitis in a young, immunocompetent Korean patient. A 35-year-old female with a one day history of bilateral swollen eyes, visual disturbance, headache, petechial skin rash, and nausea visited our clinic. She was diagnosed as having endogenous endophthalmitis associated with bacterial meningitis. Intravenous broad spectrum antibiotic therapy was initiated with cefotaxime 3 g and ubacillin 3 g, four times daily. Intravitreal antibiotic (vancomycin 1 mg/0.1 mL and ceftazidime 2 mg/0.1 mL) injections were performed in both eyes. Two weeks post presentation, the best corrected visual acuity in both eyes improved to 0.7, and inflammation of the anterior chamber and vitreous cavity was decreased. We recommend that when endogenous endophthalmitis is suspected along with meningitis, or if it is known to be present, intravitreal and intravenous antibiotics should be promptly administered to preserve vision.

Keywords: Endogenous endophthalmitis; Meningitis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Diagnosis, Differential
  • Endophthalmitis / diagnosis
  • Endophthalmitis / drug therapy
  • Endophthalmitis / etiology*
  • Eye Infections, Bacterial / diagnosis
  • Eye Infections, Bacterial / drug therapy
  • Eye Infections, Bacterial / etiology*
  • Female
  • Follow-Up Studies
  • Humans
  • Meningitis, Bacterial / complications*
  • Meningitis, Bacterial / diagnosis
  • Meningitis, Bacterial / drug therapy
  • Ophthalmoscopy

Substances

  • Anti-Bacterial Agents