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Case Reports in Infectious Diseases
Volume 2015, Article ID 897245, 4 pages
http://dx.doi.org/10.1155/2015/897245
Case Report

ESBL E. coli Urosepsis Resulting in Endogenous Panophthalmitis Requiring Evisceration of the Eye in a Diabetic Patient

1Intensive Care Unit, Columbia Asia Referral Hospital, Yeshwantpur, India
2Department of Ophthalmology, Columbia Asia Referral Hospital, Yeshwantpur, India

Received 2 May 2015; Revised 28 June 2015; Accepted 6 July 2015

Academic Editor: Sinésio Talhari

Copyright © 2015 Tejaswini Arunachala Murthy et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A primary infection in a remote site resulting in vision threatening complications like panophthalmitis in a person who is not immune-compromised is rare. We report a case of endogenous bilateral bacterial endophthalmitis progressing into panophthalmitis in one eye requiring evisceration of that eye. A patient admitted with severe ESBL E. coli urosepsis was effectively treated with source control (bilateral DJ stenting for hydroureteronephrosis) and antibiotics. She was found to have features suggestive of bilateral conjunctivitis which progressed to panophthalmitis possibly due to delay in appropriate diagnosis and treatment. Diagnosis requires a very high index of suspicion if eye involvement is noted in a patient with features of bacteraemia and early intervention could possibly produce better outcomes. To our knowledge, this is the first case of ESBL E. coli urosepsis complicated by microbiologically confirmed panophthalmitis.