Bilateral endogenous endophthalmitis – An excellent visual outcome

• Main Authors: Balbir Khan, Rajwinder Kaur
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2019-01-01
• Series: Kerala Journal of Ophthalmology
• Subjects: endogenous; endophthalmitis; meningitis; neisseria meningitidis
• Online Access: http://www.kjophthal.com/article.asp?issn=0976-6677;year=2019;volume=31;issue=3;spage=228;epage=231;aulast=Khan

We report a case of a young female patient presenting with bilateral endogenous endophthalmitis (EE) following meningitis due to Neisseria meningitidis with excellent visual outcome. A young 35-year-old female presented with chief complaint of decreased vision in both eyes (right eye more than left eye). On presentation, best-corrected visual acuity (BCVA) was <20/400 in the right eye and <20/120 in the left eye. The patient had a history of fever for which she was admitted in the hospital with the diagnosis of bacterial meningitis and received intravenous fluids with course of intravenous antibiotics. Four days after discharge from the hospital, she noticed diminution of vision; on ocular examination, the anterior segment was normal, and vitritis was present in both the eyes with multiple retinal exudates in between two arcades. Fundus fluorescein angiography and optical coherence tomography (OCT) were done. Diagnosis was made based on clinical profile secondary to bacterial meningitis. She was started on oral antibiotics for 1 week and oral steroids. The patient was kept on follow-up visits at 1 day, 1 week, 2 weeks, and monthly up to 6 months. BCVA, intraocular pressure, complete slit-lamp examination, indirect ophthalmoscopy, fundus photo, and OCT were done on each visit. She responded well to the treatment, with BCVA on the final visit being 20/80 (right eye) and 20/20 (left eye), and macular edema resolved in both eyes on the final visit. To conclude, EE is a rare complication following meningitis due to Neisseria meningitis which if diagnosed promptly and managed effectively can have a favorable prognosis.