Pediatric Bilateral Endogenous Endophthalmitis Post Meningitis: A Case Report With Literature Review

Abstract

Pediatric endogenous endophthalmitis is a rare disease that can cause serious ophthalmic damage. We report and discuss the diagnostic aspects and the clinical outcome of pediatric endogenous endophthalmitisdue to bacterial meningitis in a immunocompetent 3 year old infant with a three days history of, photophobia, purulent discharge, redness, corneal edema, hypopyon, poor red reflex and nausea.His parents brought him to our emergency department. He was diagnosed as having bilateral endogenous endophthalmitis associated with bacterial meningitis.Intravenous broad-spectrum antibiotic therapy was initiated with Cefotaxime 200 mg / kg per day in 4 slow IV injections and vancomycin15mg/kg per day in 4 IV injections. Intravitreal antibiotic (vancomycin and ceftazidime) injections were performed in both eyes. Two weeks post presentation, the best-corrected visual acuity in both eyes improved to 0.4, and inflammation of the anterior chamber and vitreous cavity was decreased. We recommend that when endogenous endophthalmitis is suspected along with meningitis, or if it is known to be present, Intravitreal and intravenous antibiotics should be promptly administered to preserve vision.