Orbital cellulitis, panophthalmitis, and ecthyma gangrenosum in an immunocompromised host withpseudomonassepticemia

Purpose To describe a case ofPseudomonas aeruginosasepticemia complicated by orbital cellulitis, panophthalmitis, and ecthyma gangrenosum. Design Observational case report. Methods An immunosuppressed 62-year-old man developed an unusual skin rash and a painful, swollen right eye with decreased visi...

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Bibliographic Details
Published in:American journal of ophthalmology 2004-01, Vol.137 (1), p.176
Main Authors: Maccheron, Luke J, Groeneveld, Erwin R, Ohlrich, Stephen J, Hilford, David J, Beckingsale, Peter S
Format: Article
Language:English
Subjects:
Antibiotics
Pneumonia
Ultrasonic imaging
Online Access:Get full text
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Summary:Purpose To describe a case ofPseudomonas aeruginosasepticemia complicated by orbital cellulitis, panophthalmitis, and ecthyma gangrenosum. Design Observational case report. Methods An immunosuppressed 62-year-old man developed an unusual skin rash and a painful, swollen right eye with decreased vision. He had myelodysplastic syndrome andP. aeruginosasepticemia. The skin rash manifested as ecthyma gangrenosum. Metastatic orbital cellulitis and panophthalmitis was diagnosed. Results Despite intravitreal and topical gentamicin, the patient eventually required enucleation. Conclusions This case represents a rare combination of events: an immunocompromised man developed pneumonia,P. aeruginosasepticemia, and endogenous seeding of thePseudomonasto the skin, orbit, and eye. Early recognition of endogenous ophthalmic disease is imperative. The prognosis of combined orbital cellulitis and panophthalmitis is poor.
ISSN:0002-9394
1879-1891
DOI:10.1016/S0002-9394(03)00721-9