gms | German Medical Science

Endogenuous endophthalmitis is a rare and severe condition. Its etiology is variable. We present a patient with an unusual differential diagnosis.

A 79-year-old female patient presented with loss of vision, redness and pain in her left eye. Clinical examination showed severe panuveitis with exophthalmus in the amaurotic eye. Suffering from an insulin-dependent diabetes this patient had a diabetic foot syndrome. Computed tomography revealed a large nasopharyngeal tumor. We suspected a relationship between this finding and the endophthalmitis. However, endoscopical investigation of this tumor confirmed the diagnosis of a meningoencephalcele. It showed typical pulse-synchronic pulsation. Microbiological examination of the vitreous sample obtained during vitrectomy showed the identical ORSA germ (oxacilline-resistant staphylococcus aureus) that had caused the abscess of the foot.

Endogenuous endophthalmitis requires thorough investigation. Its etiology can be unusual. In this case an abscess of the foot was the source of the infection. The nasopharyngeal tumor revealed to be a meningoencephalocele and therefore a coincidental finding.