Panophthalmitis due to Pasteurella septica

Ocular Cat Bite Injury: A Case Report and Literature Review

Ocular injury related to cat bites is rare, and no proper guidelines have been suggested for the treatment of such injuries. We report a rare case of zone II penetrating ocular injury secondary to a cat bite. A 49-year-old lady presented with left eye pain following a cat bite over the left eye, which occurred four hours prior to the presentation. Immediate primary closure with intravitreal antibiotic injections was given. Systemic and topical antibiotic treatments were administered. Presenting visual acuity was hand motion, which improved to 20/20 at six months follow-up. Throughout this period, there were no signs of endophthalmitis. Prompt and effective antibiotic administration with early surgical intervention contributed to a good visual prognosis in this case.

Pasteurella Multocida Panophthalmitis: A Devastating Sequela of an Industrial Penetrating Injury

Pasteurella multocida is a rare but aggressive causative organism in panophthalmitis. It is commonly transmitted to humans through contact with cats and dogs as a result of bites or scratches. We report a rare case of panophthalmitis due to P. multocida following an industrial penetrating injury.

A previously healthy 40-year-old steel factory operator developed a right eye penetrating injury after being struck accidentally by a piece of iron wire which flew into his eye during work. He complained of immediate blurring of vision and severe pain in the affected eye. During history taking, he mentioned that many stray cats wandered around his workplace, although he had no direct contact with these animals. On examination, the best-corrected visual acuity was light perception in the right eye. Slit-lamp biomicroscopy revealed injected conjunctiva and a full-thickness macerated corneal laceration wound. The anterior chamber appeared shallow with the presence of lens matter. He was treated promptly with surgical repair along with intracameral and intravenous antibiotics for six hours post-trauma. His eye condition, however, deteriorated postoperatively despite aggressive treatment with further topical, intravitreal, and systemic antibiotics.

This is the first reported case of ocular P. multocida panophthalmitis secondary to industrial penetrating injury. Our case highlights the rapidly progressive nature of P. multocida infection. It should always be considered due to the very serious nature of infection as well as its resistance to standard antibiotic treatment regimens.

Successful Treatment of Acute Endophthalmitis after Cat Bite: A Case Report and Review of the Literature

Endophthalmitis after cat bite has poor outcome particularly those associated with scleral injury. A 33-year-old Caucasian female was seen by her ophthalmologist 4 days after cat bite to her right eye with hand motion vision and obvious signs of acute endophthalmitis. She was treated with exploration and repair of scleral puncture wound, anterior chamber and vitreous cultures and intravitreal injections of vancomycin and ceftazidime. Cultures were positive for alpha hemolytic Streptococcus. She underwent a pars plana vitrectomy, cultures and repeat injection of the same antibiotics and intravitreal dexamethasone 2 days later. Cultures grew Bacillus. Endophthalmitis resolved and she regained 20/20 vision after cataract surgery 3 months later. Successful outcome of acute endophthalmitis following a cat bite to the sclera in this case was most likely due to prompt intravitreal antibiotics and early vitrectomy combined with supplemental intravitreal antibiotics and steroid therapy.

Pasteurella multocida-induced endophthalmitis after a cat scratch

Purpose

To report the case of a Japanese girl with a perforating ocular injury caused by a cat scratch, resulting in Pasteurella multocida-induced endophthalmitis.

Observations

A 10-year-old girl presented with a red eye, eye pain, and blurred vision in her right eye immediately after receiving a cat scratch. We performed lensectomy and vitrectomy for endophthalmitis 4 hours after her arrival. After culturing a sample of the vitreous humor, Pasteurella multocida was identified, and the antibiotic was changed to ampicillin. The best-corrected visual acuity of her right eye improved to 20/20 6 months after surgery.

Conclusions and importance

We present a rare case of Pasteurella multocida-induced endophthalmitis after a cat scratch. Our findings suggest the great importance of identifying the responsible bacterium and using matched antibiotics as soon as possible in such cases to prevent vision loss.

Animal-inflicted ocular and adnexal injuries in children: A systematic review

Eye injury remains the leading cause of monocular blindness in children despite 90% of injuries being potentially preventable. Children interact with animals in a variety of situations, and the associated dangers may be underestimated. Animals are capable of causing ocular and adnexal injuries that are cosmetically and visually devastating. We examine the current literature regarding the nature and severity of animal-inflicted ocular and adnexal injuries in children.

Case series of cat-scratch-inflicted full-thickness corneal lacerations and a review of the literature

BACKGROUND

  To describe the clinical features and management of cat-scratch-inflicted corneal lacerations.

DESIGN

  Retrospective, observational case series.

PARTICIPANTS

  Three patients (aged 3, 7 and 35 years) with cat-scratch-inflicted full-thickness corneal lacerations.

METHODS

  Retrospective medical chart review and review of the published literature.

MAIN OUTCOME MEASURES

  Details of clinical presentation, surgical management, antibiotic treatment and clinical outcomes on longitudinal follow-up.

RESULTS

  Cat-scratch-inflicted corneal lacerations are rare. Only five other cases were found in the literature. Wide spectrum of clinical presentation and severity of injuries exists. Two of the cases here required emergency surgical repair of the laceration; however, one case had spontaneously healed and was only diagnosed 5 years after the initial injury. One case required secondary cataract extraction and subsequent excision of a vascularized posterior lens capsule. There were no cases of secondary microbial keratitis or endophthalmitis. All cases had a favourable ocular outcome after at least 6 months of follow-up.

CONCLUSIONS

  Cat-scratch-inflicted corneal injuries are rare but do occur in Australia, in particular among younger children. If the principles of prompt surgical repair and antibiotic prophylaxis are adhered to, excellent visual outcomes are possible.

Pasteurella multocida corneal ulcer following a baseball injury

Pasteurella multocida is an ubiquitous organism that can be isolated from a variety of animals and birds. It is an infrequent ocular pathogen but can cause infection as a result of injury or animal exposure. This article reports a case of P multocida corneal ulcer following a baseball injury.

Pasteurella multocida endophthalmitis

We have recently seen an unusual case of endophthalmitis secondary to Pasteurella multocida infection. Unlike previously reported cases this patient had no previous history of animal bites or scratch wounds. Treatment included subconjunctival, parenteral, and intravitreal administration of ampicillin. Although the eye was sterilised, the patient's vision remained poor owing to the extensive amount of retinal necrosis.

Clostridium pseudotetanicum bacteremia in a patient with Pasteurella multocida conjunctivitis

Clostridium pseudotetanicum only once previously has been identified as causing disease. Pasteurella multocida has been identified only three times as the cause of purulent conjunctivitis. A very debilitated patient had C. pseudotetanicum bacteremia and P. multocida conjunctivitis from which she recovered only to die of a nosocomial Staphylococcus epidermidis septicemia, originating in a site for the administration of intravenous fluids.

Tuberculous panophthalmitis

The case of a one-year-old Nigerian with tuberculous panophthalmitis is reported. He presented initially with a localised episceleral mass which was thought to be retinoblastoma due to rapid spread over the fundus induced by subconjunctival depromedrol. Histological examination of the enucleated eye showed that the lesion was due to tuberculosis. The subsequent favorable response of the ocular and radiological chest lesions to antituberculous therapy was quite remarkable. In contrast, there was an adverse response to radiotherapy which had followed enucleation on the strong suspicion of retinoblastoma. Not unnaturally, ocular tuberculosis was not thought of because of the rarity of ocular involvement with this disease. To our knowledge, this is the first case of its type reported from the African Continent.

Corneal ulcer caused by Pasteurella multocida

A 44-year-old woman with Graves' disease and exophthalmos developed a severe corneal ulcer caused by Pasteurella multocida after being bumped on her right eye by her pet dog. The organism was transferred from the patient to an abraded rabbit cornea and produced a similiar corneal ulcer and hypopyon.

A case of bilateral Escherichia coli endogenous endophthalmitis

The first reported case of bilateral endogenous endophthalmitis is presented and discussed with reference to pertinent literature. Diagnostic and therapeutic recommendations for suspected gram-negative endophthalmitis are presented and include: immediate paracentesis of the eye for gram stain and culture, systemic therapy with an antibiotic such as gentamicin and either subconjunctival, subtenon or intraocular injection of antibiotics. Despite these measures vision may be lost, and, as in this case, enucleation necessary.