Clostridium Septicum Endogenous Endophthalmitis as the Initial Manifestation of Colorectal Carcinoma: Clinical Case Report and Literature Review

ABSTRACT

Purpose

To describe the presentation and clinical course of a case of endogenous endophthalmitis caused by Clostridium septicum, an anaerobic and gram positive bacteria.

Methods

Observational report of a clinical case presented in Spain.

Clinical case

A 61-year-old male patient was referred to our hospital with a diagnosis of endophthalmitis of his left eye since ten days prior to presentation, and a history of poor response to medical treatment. Evisceration was performed, and C. septicum was isolated from a sample of the vitreous humor. Fourteen days after surgery, the patient returned with orbital cellulitis, and exenteration was performed. Forty-two days after initial presentation, colonoscopy revealed an adenocarcinoma of the proximal colon. Surgical resection of the tumor was performed, and clinical recovery was achieved.

Conclusions

iSystemic C. septicum infection without a traumatic cause has been associated with malignancy, although an initial presentation of endophthalmitis has rarely been reported. In cases of clostridial endogenous endophthalmitis, investigation for colorectal carcinoma is indicated.

KEYWORDS:

• Bacterial endophthalmitis
• Clostridium septicum
• colorectal carcinoma
• endogenous endophthalmitis
• evisceration
• exenteration
• infectious endophthalmitis

Acknowledgments

We would like to express our gratitude to the Clinical Unit of Infectious Diseases of the Virgen del Rocío University Hospital for their kind contribution to the management of this case.

Authors’ Contributions

JLSV and AGL were the principal physicians who managed the case; they also made a major contribution to reviewing the article. MCD, AMB, OLB, MGV and JMI drafted the main body of the article, compiled the clinical data, and performed the literature search. MCM and FLH made a major contribution to reviewing the article using their clinical experience and knowledge of the published data.

Availability of data and materials

All data generated or analysed during this study are included in this published article.

Consent for publication

Written informed consent was obtained from the patient for the publication of their details and accompanying images in this manuscript. We have fully anonymised the patient in our report and they acknowledge that they cannot be identified via this paper.

Disclosure statement

The authors report no conflict of interest.

Ethics approval and consent to participate

The publication of this clinical case was approved by the Institutional Review Board of the Virgen del Rocío University Hospital (Seville, Spain).

Additional information

Funding

This study was funded by the Instituto de Salud Carlos III as part of the I+D+I National Plan (2013-2016), and co-funded by the European Union (FEDER/FSE).