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Pseudomonas aeruginosa choroidal abscess in a patient with bronchiectasis

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Abstract

Purpose: To report a case of Pseudomonas aeruginosa endophthalmitis with choroidal abscess formation in a patient with bronchiectasis. Methods: Case report. Results: A 75-year-old gentleman with bronchiectasis and P. aeruginosa pneumonia developed painless loss of right eye vision. The patient had previously undergone bronchoscopy to exclude pulmonary neoplasm. Slit-lamp examination revealed intense anterior chamber inflammation with hypopyon and B-scan ophthalmic ultrasound showed a choroidal mass consistent with choroidal abscess. Systemic and topical antibiotics did not prevent further progression of the infection. Patient declined pars plana vitrectomy and opted for enucleation. Polymerase-chain-reaction-based restriction fragment-length polymorphism (PCR-RFLP) of the enucleated eye confirmed P. aeruginosa to be the causative organism. Conclusion: P. aeruginosa cannot be completely eradicated by systemic antibiotics, and bronchial colonization of P. aeruginosa can remain a potential source for metastatic infection. P. aeruginosa choroidal abscess, previously reported only in patients with cystic fibrosis, can also occur in bronchiectasis. Physicians should therefore have a high index of suspicion of endogenous endophthalmitis and treat aggressively, especially in patients with subretinal invasion and abscess formation.

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Acknowledgments

We would like to acknowledge Dr. Biswas Jyotirmay for his expert opinion and the Department of Ocular Pathology, Vision Research Foundation, Sankara Nethralaya, Chennai, India, for their help and support, which is gratefully appreciated.

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Authors and Affiliations

  1. Eye Institute, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam road, Hong Kong SAR, China

    Kenneth K. W. Li & David Wong

  2. Department of Ophthalmology, United Christian Hospital, Kowloon, Hong Kong SAR, China

    Kenneth K. W. Li, Emily W. H. Tang & Jimmy S. M. Lai

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  1. Kenneth K. W. Li
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  2. Emily W. H. Tang
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  3. Jimmy S. M. Lai
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  4. David Wong
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Correspondence to Kenneth K. W. Li.

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Li, K.K.W., Tang, E.W.H., Lai, J.S.M. et al. Pseudomonas aeruginosa choroidal abscess in a patient with bronchiectasis. Int Ophthalmol 28, 287–290 (2008). https://doi.org/10.1007/s10792-007-9126-x

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  • DOI: https://doi.org/10.1007/s10792-007-9126-x

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