A Case of Non-Clostridial Gangrenous Panophthalmitis

ABSTRACT

PURPOSE: To report a case of non-clostridial gangrenous panophthalmitis extended directly from adjacent gangrenous skin infection METHODS: A 62-year-old woman, with diabetes mellitus, was admitted to ICU after explorative laparotomy for panperitonitis, retroperitoneal hemorrhage, and disseminated intravascular coagulation caused by traffic accident. She was referred to the ophthalmologic department because of necrotizing skin infection and panophthalmitis extended directly from an adjacent skin infection, which had developed after superficial abrasion on the left forehead. RESULTS: Necrotizing gangrenous skin infection with subcutaneous emphysema had rapidly progressed to her left face and there was panophthalmitis with subconjunctival gas bubbles. Proteus mirabilis, Serratia marcescens, Enterobacter aerogenes, and Enterococcus faecalis were cultured from the skin wound and aqueous humor, Acinetobacter baumannii, and Serratia marcescens were cultured from sump drainage. She died after 3 days because of sepsis, acute renal failure, and multiple organ failure. CONCLUSIONS: Physicians should always keep in mind that a serious infectious disease like non-clostridial gas gangrene can develop even from a superficial skin wound in immunocompromised patients like diabetics.