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BMJ Case Reports 2009; doi:10.1136/bcr.03.2009.1639
  • Reminder of important clinical lesson

Clostridium perfringens endophthalmitis following perforating eye injury

  1. Helena Lee,
  2. Zubair Idrees,
  3. Frank Kinsella
  1. Department of Ophthalmology, University Hospital Galway, Newcastle Road, Galway, Ireland
  1. Helena Lee, helenalee100{at}yahoo.co.uk
  • Published 12 July 2009

Summary

A 59-year-old man presented with endophthalmitis, following a perforating eye injury from pulling out a wire that was embedded in the ground. On presentation, his vision was perception of light (PL). Tetanus toxoid was given, and he was commenced on ciprofloxacin. A primary repair was performed. Conjunctival swabs, discharge from wound site and anterior chamber aspirate were sent for culture. The eye was tense and the anterior chamber was full of a gelatinous brown substance which precluded performance of vitrectomy. Intravitreal vancomycin and ceftazidime was given. Hourly topical fortified vancomycin and ceftazidime was given. Postoperatively, the patient’s vision remained PL with no evidence of improvement. On day 2, Clostridium perfringens was cultured. The patient was commenced on intravenous benzylpenicillin and clindamycin. Intravitreal clindamycin and vancomycin was administered. The patient was NPL on day 3. There was no evidence of response to treatment and an evisceration was performed on day 6.

Footnotes

  • Competing interests: none.

  • Patient consent: Patient/guardian consent was obtained for publication

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