DR. JIZ MARY SANTHOSH

DR. LEKHA T., DR.DIVYA BALAKRISHNAN, DR.A. GIRIDHAR

Abstract

An 8 day old term female baby,born by normal delivery was referred from outside NICU for purulent discharge from both eyes(BE)from day 3 of life.Child had tense lid edema,chemosis with total hyphema.BE Bscan was suggestive of endophthalmitis.Mother had suspicious history of oral and genital herpes.Blood,urine,CSF cultures and TORCH screen were negative.MRI brain showed multifocal abscess with ring enhancing lesions.Ocular condition worsened despite antimicrobial therapy.AC tap with intravitreal piperacillin tazobactam was given.Persistent ocular exudates prompted penetrating keratoplasty and pars plana vitrectomy.PCR of sample showed Bacillus cereus.Reduced inflammation and improvement in MRI Brain were seen on follow up.There are no previous reported cases of B.Cereus neonatal bilateral endogenous endophthalmitis.The hyphematous presentation,rapid progression and absent microbiological yield were challenges.Such cases call for the need of ocular evaluation in neonatal septicemia.