METASTATIC BACTERIAL ENDOPHTHALMITIS, A U NUSUAL INFECTIOUS-DISEASE WITH A VERY POOR-PROGNOSIS

Three men and one woman (mean age 52 years) were admitted to hospital for septicemia (2 cases), sudden partial loss of visual acuity (1 case ) and suspected conjunctivitis (1 case). Three of the patients showed risk factors (diabetes, alcohol intoxication, immunosupression). Panop hthalmitis (affecting all tunics of the eye) was apparent from the ini tial examination in all 4 cases (2 bilateral and 2 unilateral). Ocular involvement was associated with endocarditis and meningitis (pneumoco ccus) in 1 case, with nocardiosis (pulmonary, cerebral and nodal) in 1 case, and with septicemia with bacterial arthritis (Escherichia coli, streptococcus A) in 2 cases. Hemocultures were positive in 3/4 cases. The micro-organism was also detected in the joint (n=2), urine (n=1) and cerebrospinal fluid (n=1), during pulmonary transparietal puncture (n=1) and in intraocular biopsy tissue (n=1). All patients received a ppropriate antibiotic therapy intravenously and intraocularly. The inf ection was cured in all cases, but with severe functional sequelae: bl indness in 2 cases, and unilateral enucleation in the other 2 cases.