RESUMO
We report a case of Morganella morganii acute endophthalmitis following clear corneal phacoemulsification cataract surgery in which a coincident asymptomatic chronic urinary tract infection was detected postoperatively. Morganella morganii is a gram-negative bacillus that inhabits the gastrointestinal tract and is part of the normal fecal flora. It is an opportunistic pathogen usually encountered in postoperative and nosocomial settings, causing urinary tract and wound infections. Chronic urinary tract infection may be a risk factor for postoperative endophthalmitis. A dipstick urinalysis before elective cataract surgery in elderly patients with a history of recurrent urinary tract infections may be considered.
Assuntos
Endoftalmite/microbiologia , Infecções por Enterobacteriaceae , Infecções Oculares Bacterianas , Morganella morganii/isolamento & purificação , Facoemulsificação/efeitos adversos , Complicações Pós-Operatórias/microbiologia , Infecções Urinárias/microbiologia , Doença Aguda , Idoso , Idoso de 80 Anos ou mais , Antibacterianos , Quimioterapia Combinada/uso terapêutico , Endoftalmite/terapia , Infecções por Enterobacteriaceae/microbiologia , Infecções por Enterobacteriaceae/terapia , Evisceração do Olho , Infecções Oculares Bacterianas/microbiologia , Infecções Oculares Bacterianas/terapia , Feminino , Humanos , Implante de Lente Intraocular , Complicações Pós-Operatórias/terapia , Vitrectomia , Corpo Vítreo/microbiologiaRESUMO
Radiological evidence of pneumatization of the intraorbital optic nerve sheath following severe head trauma in an adult is reported. A young man was admitted to the emergency department following a high-speed motorcycle accident with unconsciousness, forehead laceration, and multiple fractures of the skull and extremities. On admission, the pupils were dilated and fixed. Computed tomography revealed right subdural hematoma with midline shift, brain stem hemorrhage, contusion of the left temporal lobe, multiple facial bone fractures, cerebral edema with intracerebral air, and meningeal pneumatization of the optic nerve sheaths bilaterally. This case demonstrates that after severe head trauma, air may extend in the optic nerve sheath, which could be a marker of severe optic nerve injury.