2023 Volume 56 Issue 7 Pages 271-275
We herein report a 60-year-old man receiving maintenance dialysis for 9 years due to diabetic nephropathy. He was diagnosed with hemodialysis vascular access-related infection with endogenous bacterial endophthalmitis. Intravenous vancomycin was started on day 1, seven days before he was admitted to our hospital. Vitrectomy and intraocular lens surgery were performed nine days after onset. He was also diagnosed with septic pulmonary embolism and bruise infection of the lower leg. Blood culture was negative, but methicillin-sensitive Staphylococcus aureus was detected in the aqueous humor, exudate from the vascular access, and exudate from the leg. We de-escalated from intravenous vancomycin to intravenous cefazolin. The vascular access-related infection, septic pulmonary embolism, and bruise infection of the lower leg were treated successfully. Enucleation was avoided, but he subsequently showed no light perception. We should keep in mind the possibility of endogenous bacterial endophthalmitis complicated with vascular access-related infection. Endogenous bacterial endophthalmitis should be diagnosed and treated as soon as possible for a better outcome and the avoidance of enucleation.
