RESUMEN
Mujer de 62 años con disminución de la agudeza visual bilateral rápidamente progresiva y panuveítis con celulitis orbitaria, asociadas a mal estado general, emesis y fiebre. Se diagnosticó septicemia por Klebsiella pneumoniae y panoftalmitis endógena bilateral. La afectación ocular progresó rápidamente a escleroqueratitis y perforación en ambos ojos, pese a recibir manejo antibiótico sistémico de amplio espectro. Finalmente, la paciente requirió enucleación bilateral. Los cultivos microbiológicos de las piezas quirúrgicas identificaron Klebsiella pneumoniae y Candida magnoliae. Según nuestro conocimiento, es el tercer caso publicado que haya requerido enucleación o evisceración bilateral por panoftalmitis endógena y el primer caso de infección ocular endógena causada por Candida magnoliae
The case is presented of a 62 year-old woman with a rapid, progressive bilateral decrease in visual acuity and panuveitis with orbital cellulitis. She was also in poor general condition, with emesis and fever. Septicaemia due to Klebsiella pneumoniae and bilateral endogenous panophthalmitis were diagnosed. The ocular infection quickly progressed to sclerokeratitis and bilateral perforation despite broad spectrum systemic antibiotic management, and eventually the patient required bilateral enucleation. Microbiological cultures of the surgical pieces identified Klebsiella pneumoniae and Candida magnoliae. To our knowledge, this is the third published case that required bilateral enucleation or evisceration due to endogenous panophthalmitis, and the first case of endogenous ocular infection caused by Candida magnoliae
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Candidiasis/cirugía , Enucleación del Ojo , Infecciones por Klebsiella/cirugía , Klebsiella pneumoniae/aislamiento & purificación , Panoftalmitis/cirugía , Antibacterianos/uso terapéutico , Candidiasis/microbiología , Coinfección/cirugía , Terapia Combinada , Perforación Corneal/etiología , Progresión de la Enfermedad , Infecciones por Klebsiella/microbiología , Celulitis Orbitaria/tratamiento farmacológico , Celulitis Orbitaria/cirugía , Panoftalmitis/tratamiento farmacológicoRESUMEN
The case is presented of a 62 year-old woman with a rapid, progressive bilateral decrease in visual acuity and panuveitis with orbital cellulitis. She was also in poor general condition, with emesis and fever. Septicaemia due to Klebsiella pneumoniae and bilateral endogenous panophthalmitis were diagnosed. The ocular infection quickly progressed to sclerokeratitis and bilateral perforation despite broad spectrum systemic antibiotic management, and eventually the patient required bilateral enucleation. Microbiological cultures of the surgical pieces identified Klebsiella pneumoniae and Candida magnoliae. To our knowledge, this is the third published case that required bilateral enucleation or evisceration due to endogenous panophthalmitis, and the first case of endogenous ocular infection caused by Candida magnoliae.
