Background: To compare blood culture bottles and conventional media for the vitreous culture in patients with clinically suspected infectious endophthalmitis.

A 47-year-old Thai man, who had recently been diagnosed with active pemphigus vulgaris (PV) and treated with oral prednisolone together with intravenous dexamethasone, presented with severe ocular pain and light perception vision of the left eye for 4 days. Ophthalmic examination revealed periorbital soft tissue swelling with marked intraocular inflammation in the left eye. Severe panophthalmitis was diagnosed. Enucleation was performed after failure of intravenous antibiotics administration. Vitreous culture revealed Aeromonas hydrophila but no primary source of infection was clearly identified. An immunocompromised status accompanied with corticosteroid treatment is a risk factor for septicemia. A. hydrophilapanophthalmitis was detected in the PV patient, and this organism caused a rapid disease progression with poor visual prognosis.