Endogenous Endophthalmitis and Missed Diagnoses
Retrospective study describes how endogenous endophthalmitis often presents without systemic symptoms
Objective: To highlight the diagnostic challenges and clinical presentation of endogenous endophthalmitis.
Approach: Study Design: Retrospective review of 50 eyes from 41 patients with culture-proven endogenous endophthalmitis treated between 2013 and 2024.Data Collection: Examined clinical presentation, microbiological findings, systemic associations, management strategies, and visual outcomes.Key Findings: 73% of patients presented in an outpatient setting; only 39% reported systemic symptoms. Blurred vision (88%) was the most common presenting complaint, followed by ocular pain (42%) and redness (27%). Candida species were the leading causative organism, accounting for 50% of positive vitreous cultures. 56% of patients had an identifiable infectious source, primarily from indwelling medical devices. 12% of patients were misdiagnosed with alternative inflammatory conditions before the correct diagnosis. Blood cultures were positive in 56% of cases. Interpretation: Endogenous endophthalmitis often presents primarily as an ocular issue, complicating timely diagnosis and treatment.
Limitations: Retrospective nature may limit the generalizability of findings. Potential for misdiagnosis may affect reported outcomes. Conclusion: Endogenous endophthalmitis poses significant diagnostic and therapeutic challenges, necessitating high clinical suspicion in at-risk patients.
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