Fulminant Acute Postoperative Endophthalmitis caused by Pseudomonas stutzeri in a Healthy Elderly Male

Abstract

Objective: To report a case of acute postoperative endophthalmitis following cataract surgery due to Pseudomonas stutzeri in a healthy elderly male. Methods: This is a case report. Results: A non-hypertensive, non-diabetic male in his late 60s consulted due to eye pain and blurred vision 5 days after an uncomplicated extracapsular cataract extraction with posterior chamber intraocular lens implantation (PCIOL) on his left eye. On examination, the visual acuity was light perception. Slit-lamp examination showed ciliary injection, conjunctival congestion, mild corneal edema with Descemet membrane folds, hazy anterior chamber with fibrin and a 2-millimeter hypopyon, and a visible PCIOL. IOP was 10 mmHg with no leak on Seidel’s test, and there was poor view of the fundus. B-scan ultrasonography showed findings consistent with endophthalmitis. He was given topical, intravitreal, and systemic antibiotics, and emergency vitrectomy was done. The vitreous sample culture revealed Pseudomonas stutzeri. Despite aggressive medical and surgical management, vision loss was not prevented. Conclusion: Acute postoperative endophthalmitis from Pseudomonas stutzeri is rare; if not recognized and treated promptly, this complication has devastating outcomes. It may present with a fulminant course regardless of the associated risks for infection. Prevention, early recognition, and timely management can prevent unfavorable visual outcomes.

Keywords

• endophthalmitis
• cataract surgery
• pseudomonas stutzeri