Open AccessPosterior scleral perforation due to endogenous endophthalmitis in a pregnant with selective IgA deficiency
Author(s) -
Marina Aguilar-González,
Emma Marín-Payá,
Marta Pérez-López,
Maria Ángeles Bort-Martínez,
J. Aviñó-Martínez,
Enrique EspañaGregori
Publication year - 2022
Publication title -
romanian journal of ophtalmology
Language(s) - English
Resource type - Journals
eISSN - 2501-2533
pISSN - 2457-4325
DOI - 10.22336/rjo.2022.19
Subject(s) - medicine , orbital cellulitis , evisceration (ophthalmology) , corneal perforation , endophthalmitis , surgery , choroid , perforation , phthisis bulbi , pseudomonas infection , uveitis , ophthalmology , pseudomonas aeruginosa , visual acuity , cellulitis , pathology , retina , alternative medicine , materials science , genetics , biology , bacteria , optics , punching , metallurgy , physics
We present the case of a 35-year-old female patient, pregnant in her third trimester, with no ophthalmologic history of interest and a medical history of IgA deficiency syndrome with bronchiectasis as the only symptomatology, who came to another center with clinical symptoms of ocular discomfort. She was initially diagnosed with anterior uveitis and treated with topical and periocular corticosteroids. Edema and palpebral erythema appeared a few days later and she was diagnosed with idiopathic orbital inflammation and was treated with intravenous (I.V.) corticosteroids, which led to the appearance of a purulent palpebral and subconjunctival collection with a diagnosis of orbital cellulitis. At this time, she came to our center, where ultrasound and magnetic resonance imaging (MRI) showed intraocular and scleral destructuring with scleral perforation. The subconjunctival abscess was drained, being positive for pseudomonas aeruginosa , and sputum culture was positive for Pseudomonas aeruginosa , so she was diagnosed with endogenous endophthalmitis due to transient Pseudomonas aeruginosa bacteremia in the context of IgA deficiency syndrome and treated with antibiotherapy. Despite the improvement of the infectious clinic, the persistence of positive cultures for pseudomonas aeruginosa and the evolution to phthisis bulbi at 2 months led to definitive treatment with evisceration. To our knowledge, this is the first reported case of endogenous endophthalmitis associated with IgA deficiency and the first reported case of endogenous bacterial endophthalmitis caused by pseudomonas aeruginosa during pregnancy.