Li Z, Gao W, Tian YM, Xiao Y. Choroidal metastatic mucinous abscess caused by Pseudomonas aeruginosa: A case report. World J Clin Cases 2021; 9(30): 9244-9254 [PMID: 34786411 DOI: 10.12998/wjcc.v9.i30.9244]
Corresponding Author of This Article
Wen Gao, MM, Attending Doctor, Ophthalmic Center, General Hospital of Xinjiang Military Region, No. 754 Beijing Middle Road, Urumqi 830011, Xinjiang Uygur Autonomous Region, China. 864591003@qq.com
Research Domain of This Article
Ophthalmology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Oct 26, 2021; 9(30): 9244-9254 Published online Oct 26, 2021. doi: 10.12998/wjcc.v9.i30.9244
Choroidal metastatic mucinous abscess caused by Pseudomonas aeruginosa: A case report
Zhao Li, Wen Gao, Yan-Ming Tian, Yun Xiao
Zhao Li, Wen Gao, Yun Xiao, Ophthalmic Center, General Hospital of Xinjiang Military Region, Urumqi 830011, Xinjiang Uygur Autonomous Region, China
Yan-Ming Tian, PLA Eye Center, General Hospital of Xinjiang Military Region, Urumqi 830011, Xinjiang Uygur Autonomous Region, China
Author contributions: Li Z and Gao W performed the analyses and wrote the manuscript; Gao W contributed to the conception of the study; Tian YM performed the operation; Yun Xiao helped perform the analysis with constructive discussions; Li Z and Gao W were responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016). The manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wen Gao, MM, Attending Doctor, Ophthalmic Center, General Hospital of Xinjiang Military Region, No. 754 Beijing Middle Road, Urumqi 830011, Xinjiang Uygur Autonomous Region, China. 864591003@qq.com
Received: May 26, 2021 Peer-review started: May 26, 2021 First decision: June 15, 2021 Revised: June 15, 2021 Accepted: July 28, 2021 Article in press: July 28, 2021 Published online: October 26, 2021
Abstract
BACKGROUND
Pseudomonas aeruginosa (P. aeruginosa) is considered a common pathogenic bacterium. Choroidal metastatic mucinous abscess caused by P. aeruginosa is rarely reported.
CASE SUMMARY
We describe the diagnostic and treatment processes of a case involving a complex choroidal space-occupying lesion. Our analyses of early clinical manifestations revealed a high possibility of choroidal melanoma, as indicated by the choroidal space-occupying lesion and uveitis. Further magnetic resonance imaging results revealed no positive evidence for the diagnosis of choroidal melanoma. The exact properties of the space-occupying lesion could not be ascertained prior to surgery. However, the lesion was subsequently confirmed as a metastatic abscess by diagnostic vitrectomy. The occupying lesion was found to occupy 75% of the vitreous cavity in the surgery. The entire white viscous tissue was completely removed, and the necrotic retina was cleaned up. After surgery, microbiological culture revealed mucoid P. aeruginosa, which was sensitive to a variety of antibiotics. The bacterial infection grew and disseminated towards the outside of the eye. After the fifth injection, the left eye was successfully retained.
CONCLUSION
This is a peculiar case because a huge, local, space-occupying lesion had formed due to the dissemination of low-toxic mucinous P. aeruginosa in the blood from the lungs to the choroid. After surgical removal, the bacteria were able to re-grow; thus, local infection re-spread following surgery. The patient lost vision, but we managed to retain the full structure of the eyeball and eliminated the focus of infection.
Core Tip: Pseudomonas aeruginosa (P. aeruginosa) is considered a common pathogenic bacterium. We present herein a rare case of choroidal metastatic mucinous abscess caused by P. aeruginosa. This case is peculiar because the abscess formed due to the dissemination of bacterial infection from the lung to the eye and was confined to the choroid. Analysis of blood from the lungs revealed that the P. aeruginosa had disseminated into the choroidal blood vessels. Due to the reduced blood flow, the bacteria had reproduced in the choroid and formed a mucinous abscess.
