BACKGROUND
Pseudomonas aeruginosa
(
P. aeruginosa
) is considered a common pathogenic bacterium. Choroidal metastatic mucinous abscess caused by
P. aeruginosa
is rarely reported.
CASE SUMMARY
We describe the diagnostic and treatment processes of a case involving a complex choroidal space-occupying lesion. Our analyses of early clinical manifestations revealed a high possibility of choroidal melanoma, as indicated by the choroidal space-occupying lesion and uveitis. Further magnetic resonance imaging results revealed no positive evidence for the diagnosis of choroidal melanoma. The exact properties of the space-occupying lesion could not be ascertained prior to surgery. However, the lesion was subsequently confirmed as a metastatic abscess by diagnostic vitrectomy. The occupying lesion was found to occupy 75% of the vitreous cavity in the surgery. The entire white viscous tissue was completely removed, and the necrotic retina was cleaned up. After surgery, microbiological culture revealed mucoid
P. aeruginosa
, which was sensitive to a variety of antibiotics. The bacterial infection grew and disseminated towards the outside of the eye. After the fifth injection, the left eye was successfully retained.
CONCLUSION
This is a peculiar case because a huge, local, space-occupying lesion had formed due to the dissemination of low-toxic mucinous
P. aeruginosa
in the blood from the lungs to the choroid. After surgical removal, the bacteria were able to re-grow; thus, local infection re-spread following surgery. The patient lost vision, but we managed to retain the full structure of the eyeball and eliminated the focus of infection.