Abstract

An 83-year-old man presented with a red right eye, rapidly deteriorating vision and no history of ocular trauma or surgery. The patient had no vitritis on presentation, which confounded a diagnosis. Vitreous tap and injection of intravitreal antibiotics was performed day 2, however, the eye could not be saved and was surgically removed. Tissue culture reported Aeromonas hydrophila as the infective organism. Investigation into the source of infection revealed mural thickening of the caecum with CT of the abdomen. On completion of antibiotic treatment, the patient was referred for a colonoscopy, which revealed low grade adenocarcinoma of the colon, and subsequently underwent laparoscopic hemicolectomy. While the source of infection was unable to be identified, it is possible the infection seeded from the patients underlying malignancy. This case demonstrates the importance of thoroughly investigating patients with A. hydrophila endogenous endophthalmitis, as it can be an indication of underlying malignancy.