Background: There are still many unknowns regarding the dynamics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus which caused coronavirus disease 2019 (COVID-19), and its effects on ocular tissues. This report presents a case of endophthalmitis, where a search for SARS-CoV-2 was conducted in the vitreous fluid.
Patient: The patient was a 46-year-old woman who contracted COVID-19 during chemotherapy after surgery for abdominal tumor. Four days later, she experienced a central venous (CV) port infection, and was diagnosed with endophthalmitis in her right eye the next day. After the CV port was removed, systemic administration of antibiotics was initiated, and intravitreal antibiotics were administered. Methicillin-resistant Staphylococcus aureus (MRSA) was detected in the CV port tip. After the easing of COVID-19 restrictions, various tests were conducted. The patient exhibited a corrected visual acuity of 0.5 in her right eye, vitreous opacities, and decreased electroretinogram amplitudes. She immediately underwent vitrectomy. The vitreous fluid culture and SARS-CoV-2 polymerase chain reaction (PCR) in the vitreous fluid were negative, but a SARS-CoV-2 S-antibody was detected at a high level of 11,200 U/mL. The final visual activity was 1.2 in her right eye.
Conclusion: We examined intraocular SARS-CoV-2 antibodies in a case of MRSA endophthalmitis and detected high levels of a SARS-CoV-2 S-antibody.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 128: 113-118, 2024.