Unilateral Endogenous Bacterial Endophthalmitis Post-Coronavirus Disease-19 in an Healthy Asian Indian Male.

Abstract

Coronavirus disease 2019 (COVID-19) is associated with ocular involvement either during or after the infection. These include conjunctivitis, conjunctival hyperemia, chemosis, epiphora, reactivation of anterior uveitis, or presenting as anterior sclero-uveitis, cotton wool spots, retinal hemorrhages, retinal artery/vein occlusion, ophthalmic artery occlusion, panuveitis, papillophlebitis, central serous retinopathy, presumed fungal endophthalmitis, and multifocal chorioretinitis. A 47-year-old Asian Indian male was diagnosed with COVID-19 and had no other systemic history of note at the time of admission. Three weeks later, he developed sudden loss of vision in the right eye (OD). Visual acuity in OD was perception of light. OD had features of endophthalmitis. OD underwent pars plana vitrectomy with intravitreal antibiotics. Anterior chamber tap for fungal culture and polymerase chain reaction for panfungal genome was negative. Culture of ocular specimens did not reveal bacterial growth. Vitreous sample showed few Gram-positive cocci in singles and pairs with no evidence of fungal elements. Polymerase chain reaction for eubacterial genome was positive. He was treated with topical and systemic antibiotics and steroids. Final follow-up 6 weeks later, OD had a best-corrected visual acuity which was 20/200 with a quiet anterior chamber, cataract, with a macular traction and reduced sub retinal exudates and fluid. Post-COVID-19 sequelae causing sight-threatening manifestations as illustrated by this case report needs early recognition and prompt treatment to achieve a favorable visual outcome.