METASTATIC BACTERIAL ENDOPHTHALMITIS - A REPORT OF 4 CASES ALL LEADING TO BLINDNESS

Purpose: To draw attention to the rare but severe entity of endophthal mitis as encountered due to metastatic spread of bacteria. Methods: We report our experience from four cases of metastatic bacterial endopht halmitis. Results: Systemic infection (Pneumococcus meningitis) was ev ident in two cases, but in the other two there was no early clue to sy stemic infection. Eventually, however, endocardial vegetations were di sclosed as the source of bacterial emboli (E.coli, peptostreptococcus) . In the most atypical patient, magnetic resonance scanning had indica ted disseminated brain tumours, and only autopsy revealed the infectio us nature of the disease. Ocular ultrasonography being part of the wor k-up, the four eyes under study all showed marked morphological intrao cular changes, including 'solid tumour' in the presumed neoplastic cas e. Conclusion: Our cases stress the severity of metastatic bacterial e ndophthalmitis and the easily missed early diagnosis, even where exper ienced clinicians are involved. The role of diagnostic ultrasound is d iscussed.