J Korean Ophthalmol Soc.  2020 Jul;61(7):819-822. 10.3341/jkos.2020.61.7.819.

Bilateral Infectious Keratitis Caused by Pseudomonas aeruginosa in a Colon Cancer Patient

• Kim HY
• Jang SG
• Lee JS

• KMID: 2504324
• DOI: http://doi.org/10.3341/jkos.2020.61.7.819

Abstract

Purpose
To report a case of successful treatment of bilateral infectious keratitis combined with endophthalmitis caused by Pseudomonas aeruginosa in an immunocompromised patient.
Case summary
A 66-year-old male with colon cancer and lung metastasis was referred to our clinic with ocular pain and reduced visual acuity in both eyes for 3 days. Visual acuity was “light perception” in both eyes at the first visit. On slit lamp examination, he presented with corneal central necrosis with mucopurulent discharge and anterior chamber hypopyon in both eyes. The left eye especially had vitreous haziness using a B-scan. Pseudomonas aeruginosa was detected in the corneal scrape culture and percutaneous transhepatic biliary drainage culture. After administration of topical eye drops, intravitreal injection, and systemic antibiotics, visual acuity improved from “light perception” to 20/63 in the right eye and to 20/125 in the left eye.
Conclusions
Although bilateral corneal ulcers combined with endophthalmitis induced by Pseudomonas aeruginosa are rare it can occur in immunocompromised patients. In the case of corneal ulcers combined with endophthalmitis, thorough ocular examinations and active treatments with intravitreal injections and systemic administration of antibiotics can help to recover vision.

Keyword

Colon cancer; Immunocompromised patient; Pseudomonas aeruginosa keratitis