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Year : 2020  |  Volume : 17  |  Issue : 3  |  Page : 229-232

A case of endogenous endophthalmitis in COVID- 19 pandemic

Vitreo Retina Department, Aditya Jyot Eye Hospital, Mumbai, Maharashtra, India

Correspondence Address:
Sonam Verma
Dr Kishan Eye Care and Laser Surgery Center, 127 Kanchan Bagh, Opp. Hotel Crown Palace, Indore - 452 001, Madhya Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/am.am_71_20

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The home isolation from lockdown has limited the exchange of microflora in community. It benefits in limiting 2019 nCOV but collateral depletion in memory-based immunity has its own devastating consequences. It triggers subclinical infections, by reactivation of dormant pathogens or evolution of normal microflora into multidrug-resistant strains, which may escalate to endogenous infections. With the following case report, as a consequence of such unfortunate circumstances, we emphasize upon timely management of endophthalmitis, an ocular emergency, on promptly ruling out inflammatory etiologies, with modifications in protocol and due precautions as per the current COVID situation. The case demonstrates rapid response to acute endophthalmitis in a tertiary eye hospital with 24 h emergency services in a megacity amidst lockdown. The condition masqueraded as uveitis initially hence appropriate treatment got delayed by a week. Immediate aqueous sample collection for microbiological investigation and medical treatment with intravitreal injection antibiotics and steroid followed by intensive therapy with topical steroids and fortified drops aided in local delivery of drugs in better concentration than commercially available vials. Further surgical intervention, provided vitreous sample for microbial testing, debulked infection from vitreous. Growth of Enterobacter hormaechi was observed in vitreous sample, uncommon in endogenous endophthalmitis. Blood sample revealed drug-resistant Staphylococcus hominis. The patient regained vision successfully from mere perception of light to 6/60 within a few weeks. Such endogenous infections are highly alarming and necessitate urgent replacement of antibiotic abuse, over the counter treatments, approaching quacks, and fear of going to hospital with meticulous management by concerned specialists under updated protocols.

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