Publicação
Endogenous Endophthalmitis and Urosepsis by Escherichia coli: An Unexpected Association
| Resumo: | Endophthalmitis is a pathology that requires a high degree of suspicion for the diagnosis, especially in immunocompromisedpatients. The rapid establishment of diagnosis and prompt initiation of treatment may avoid amaurosis. The authorspresent a case of a 70-year-old woman with bilateral lung metastatic disease of a poorly differentiated large cells neuroendocrine carcinoma under chemotherapy (carboplatin and docetaxel) who was admitted five days after her last cyclebecause of febrile neutropenia and urosepsis with bacteriemia by Escherichia coli. After the admission, the patient suddenlydeveloped acute inflammatory signs and pruritus on the right eye, which progressed exuberantly over the next 24 hours. Acomputed tomography scan and a panophthalmitis were performed, with proptosis and extensive cellulitis of peri-orbital tissues was revealed. A diagnosis of endophthalmitis due to Escherichia coli hematogenous dissemination was made anda collection of aqueous humor was performed without isolation of microbiological agents. The patient was treated withintravitreal injection of antibiotic therapy (single dose), as well as with topical and systemic antibiotic for 21 days, showedgood evolution and no enucleation was necessary for control of infectious focus, but complete amaurosis of the affectedeye occurred. |
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| Autores principais: | Henriques Ferreira, Inês |
| Outros Autores: | Vidigal Bertão, Manuela; Medeiros, Pedro; Zão, Ana; Reis, Ernestina |
| Assunto: | Endoftalmite Hospedeiro Imunocomprometido Infecções por Escherichia coli Infecções Urinárias Endophthalmitis Escherichia coli Infections/complications Immunocompromised Host Urinary Tract Infections |
| Ano: | 2017 |
| País: | Portugal |
| Tipo de documento: | artigo |
| Tipo de acesso: | unknown |
| Instituição associada: | Sociedade Portuguesa de Medicina Interna |
| Idioma: | português |
| Origem: | Revista Portuguesa de Medicina Interna |
| Resumo: | Endophthalmitis is a pathology that requires a high degree of suspicion for the diagnosis, especially in immunocompromisedpatients. The rapid establishment of diagnosis and prompt initiation of treatment may avoid amaurosis. The authorspresent a case of a 70-year-old woman with bilateral lung metastatic disease of a poorly differentiated large cells neuroendocrine carcinoma under chemotherapy (carboplatin and docetaxel) who was admitted five days after her last cyclebecause of febrile neutropenia and urosepsis with bacteriemia by Escherichia coli. After the admission, the patient suddenlydeveloped acute inflammatory signs and pruritus on the right eye, which progressed exuberantly over the next 24 hours. Acomputed tomography scan and a panophthalmitis were performed, with proptosis and extensive cellulitis of peri-orbital tissues was revealed. A diagnosis of endophthalmitis due to Escherichia coli hematogenous dissemination was made anda collection of aqueous humor was performed without isolation of microbiological agents. The patient was treated withintravitreal injection of antibiotic therapy (single dose), as well as with topical and systemic antibiotic for 21 days, showedgood evolution and no enucleation was necessary for control of infectious focus, but complete amaurosis of the affectedeye occurred. |
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