Post-surgical endophthalmitis with secondary meningitis. About a case

A 61-year-old man presented hyperacute endophthalmitis due to Proteus mirabilis after a pars plana vitrectomy. In the first examination (24 h after surgery), visual acuity (VA) was of hand movement, biomicroscopy showed edematous cornea, Tyndall ++++ and fibrin membrane, with vitritis and impossibility of visualizing retina details. Treatment with intravitreal injections was performed. Despite the treatment, the patient's symptoms worsened, and he began with poor general condition, fever, and leukocytosis, requiring hospitalization and intravenous treatment because of a diagnosis of secondary meningitis due to post-surgical endophthalmitis. The patient required enucleation of the affected eye without prosthesis placement.

Even though post-surgical bacterial endophthalmitis is usually an infection confined to the eye, this clinical case demonstrates the possibility of the infection spreading to the rest of the body, potentially endangering the patient's life.