Endogenous endophthalmitis caused by urinary tract infection: A case report

Abstract

Rationale: Endogenous endophthalmitis is a vision-threatening intraocular infection caused by hematogenous spread of infectious organisms from distant sites. Patient concerns: A 71-year-old man with a history of fever and dysuria 5 days prior to presentation presented with sudden loss of vision in his left eye. The patient had no history of ocular surgery or trauma, and ocular examination revealed a large amount of exudative plaque covering the pupil. Therefore, fundus examination was not feasible. B-scan ultrasonography revealed a dome-shaped subretinal mass with an exudative retinal detachment. Diagnosis: Endogenous endophthalmitis was diagnosed on the basis of these findings. Interventions: The patient underwent pars plana vitrectomy and the early postoperative course was favorable. Outcomes: Vitreous cultures grew gram-negative bacilli, identified as Klebsiella pneumonia. Urinalysis revealed white blood cells (++) and urinary tract infection was the only identifiable risk factor for endogenous endophthalmitis. Lessons: Urinary tract infection is an independent risk factor for endogenous endophthalmitis.