Methicillin-resistant Staphylococcus aureus buckle infection complicated by endophthalmitis and presumed choroidal abscess in a patient with ulcerative colitis

Abstract

This patient presented with excessive pain, lid swelling, erythema, heat and limitations of extraocular movement (OD) nine days after a scleral buckle (SB) and pneumopexy surgery. Complicated buckle infection with endophthalmitis was impressed. Bacterial culture yielded methicillin-resistant Staphylococcus aureus. A choroidal abscess was identified 1 week after the episode. Complete visual recovery from hand motion to 20/30 (OD) was achieved with buckle removal, subconjunctival and intravitreal antibiotics. Endophthalmitis and choroidal abscess formation after SB surgery is extremely rare. Host factors including ulcerative colitis may play a role in causing the severe buckle infection of this patient.

Pseudomonal Choroidal Abscess After Routine Pars Plana Vitrectomy in an Immunosuppressed Patient

“…Rarely, it could be due to direct external trauma 7,8 and contiguous spread from infected periocular hardware. 7 Overall, choroidal abscesses are rare occurrences. Based on our literature search in the PubMed database, there have been six reported cases 3,4,6,9,10 of pseudomonal choroidal abscess, summarized in Table 1.…”

“…5 The causative organisms can either be fungal, 2 such as Aspergillus, or bacterial, 1,3-10 such as Nocardia, Staphylococcus, and Pseudomonas. Rarely, it could be due to direct external trauma 7,8 and contiguous spread from infected periocular hardware. 7 Overall, choroidal abscesses are rare occurrences.…”

“…Rarely, choroidal abscess could affect immunocompetent individuals at risk of choroidal seeding from a systemic source. 5 The causative organisms can either be fungal, 2 such as Aspergillus , or bacterial, 1,3–10 such as Nocardia , Staphylococcus , and Pseudomonas . Rarely, it could be due to direct external trauma 7,8 and contiguous spread from infected periocular hardware.…”

“…Rarely, it could be due to direct external trauma 7,8 and contiguous spread from infected periocular hardware. 7…”