Citation

Deb AK, Neena A, Chowdhury SS, Sarkar S, Suneel S, Gokhale T. Natl. Med. J. India 2023; 36(6): 367-369.

Copyright

(Copyright © 2023, New Delhi All India Institute of Medical Sciences)

DOI

10.25259/NMJI_945_20

PMID

38909296

Abstract

Enterobacter is a Gram-negative anaerobic bacillus. Enterobacter-associated endophthalmitis is rare. We report Enterobacter cloacae-associated traumatic endophthalmitis following a water gun injury with no visible external entry wound. A 46-year-old man presented with features masquerading as traumatic uveitis in his left eye following injury by water stream from a toy gun. He was started on topical steroids but within 2 days of initial presentation, there was worsening of vision, presence of hypopyon in the anterior chamber and presence of vitreous exudates confirmed on ocular ultrasound B-scan. Endogenous endophthalmitis was ruled out by extensive work-up including sterile urine and blood cultures. Emergency vitrectomy was done along with lensectomy and silicone oil implantation. E. cloacae were isolated from the vitreous sample, which were sensitive to all standard antibiotics tested. Final visual acuity was 20/200. Traumatic endophthalmitis is usually preceded by a penetrating ocular injury in the form of a corneal, limbal or scleral tear with or without choroidal tissue prolapse and vitreous prolapse. A high index of suspicion is, therefore, needed for the diagnosis of endophthalmitis in the absence of corneal injury following water jet trauma to the eye.

Language: en

Keywords

Humans; Male; Middle Aged; *Endophthalmitis/microbiology/diagnosis/etiology; *Enterobacter cloacae/isolation & purification; *Enterobacteriaceae Infections/diagnosis/etiology/microbiology/drug therapy; *Vitrectomy; Anti-Bacterial Agents/therapeutic use