Panophthalmitis due to clostridium septicum

Am J Ophthalmol. 2004 May;137(5):942-4. doi: 10.1016/j.ajo.2003.10.030.

Abstract

Purpose: To describe patient survival in a rare case of endogenous Clostridium septicum sepsis with panophthalmitis.

Design: Observational case report.

Methods: Both eyes of a female patient were examined in a hospital setting.

Results: A 68-year-old woman had right orbital pain, proptosis, panophthalmitis, mental confusion and fever for 2 days. Blood cultures were significant for Clostridium septicum. The patient did not improve after treatment with intravenous broad-spectrum antibiotics and the right eye was enucleated. The patient survived the acute infection and extensive systemic evaluation revealed an undiagnosed colon carcinoma that may have been responsible for colonization and vascular dissemination of Clostridium septicum.

Conclusions: Clostridium septicum panophthalmitis and sepsis can be the presenting sign in patients with unsuspected malignancies, particularly colon cancer. Patients can survive the infection with aggressive therapy with systemic antibiotics combined with removal of the infected tissue.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Aged
  • Anti-Bacterial Agents
  • Bacteremia / microbiology*
  • Bacteremia / therapy
  • Clostridium / isolation & purification
  • Clostridium Infections* / microbiology
  • Clostridium Infections* / therapy
  • Colonic Neoplasms / diagnosis
  • Diabetes Mellitus, Type 2 / complications
  • Disease-Free Survival
  • Drug Therapy, Combination / therapeutic use
  • Eye Enucleation
  • Eye Infections, Bacterial* / microbiology
  • Eye Infections, Bacterial* / therapy
  • Female
  • Humans
  • Hypertension / complications
  • Panophthalmitis / microbiology*
  • Panophthalmitis / therapy

Substances

  • Anti-Bacterial Agents