ABSTRACT Endogenous endophthalmitis is an intraocular infection that results from hematogenous spread of organisms from a distant source of infection. Facial cellulitis is rarely reported as a focus of infection. We report a case of 51-year-old unconscious woman presenting with fever, facial swelling, and decreased visual acuity secondary to facial cellulitis, endogenous endophthalmitis and end-stage renal disease(ESRD). Generally systemic antibiotics in endophthalmitis have low efficacy because of the blood-ocular barrier. The management of endophthalmitis begins with intravitreal antibiotic injections and if the response is not favorable to do a vitrectomy. Twelve hours after the intravitreal antibiotic injection, vitrectomy was considered because of worsening of the vitreal cloudiness. However, the patient's general medical condition precluded vitrectomy. We experienced successful treatment with intravitreal antibiotic injection and continuous intravenous antibiotic administration because of the breakdown of the blood-ocular barrier due to ocular inflammation, especially in the setting of systemic vascular and fluid homeostatic changes.
Cite this paper
M. Ho Kang, M. Seong, J. Hak Lee and H. Yoon Cho, "Endogenous Endophthalmitis Associated with Facial Cellulitis After a Tongue Bite," Open Journal of Ophthalmology, Vol. 2 No. 3, 2012, pp. 85-88. doi: 10.4236/ojoph.2012.23018.
 S. R. Smith, A. J. Kroll, P. L. Lou and E. A. Ryan, “Endogenous Bacterial and Fungal Endophthalmitis,” International Ophthalmology Clinics, Vol. 47, No. 2, 2007, pp. 173-183. doi:10.1097/IIO.0b013e31803778f7
 R. Argelich, N. Ibá?ez-Flores, J. Bardavio, A. Burés-Jelstrup, G. García-Segarra, R. Coll-Colell, V. Cuadrado and F. Fernández-Monrás, “Orbital Cellulitis and Endogenous Endophthalmitis Secondary to Proteus Mirabilis Chole-cystitis,” Diagnostic Microbiology and Infectious Dis-ease, Vol. 64, No. 4, 2009, pp. 442-444.
 T. L. Jackson, S. J. Eykyn, E. M. Graham and M. R. Stanford, “Endogenous Bacterial Endophthalmitis: A 17-Year Prospective Series and Review of 267 Reported Cases,” Survey of Ophthalmology, Vol. 48, No. 4, 2003, pp. 403- 423. doi:10.1016/S0039-6257(03)00054-7
 T. Ness, K. Pelz and L. L. Hansen, “Endogenous Endophthalmitis: Microorganisms, Disposition and Prognosis,” Acta Ophthalmologica Scandinavica, Vol. 85, No. 8, 2007, pp. 852-856.
 A. Ebneter, L. Goold and J. S. Gilhotra, “A Rare Case of Endogenous Streptococcus Group C Endophthalmitis Associated with Cellulitis,” Eye, Vol. 25, No. 9, 2011, pp. 1239-1240. doi:10.1038/eye.2011.124
 E. Peker, E. Cagan, M. Dogan, A. Kilic, H. Caksen and O. Yesilmen, “Periorbital Cellulitis Caused by Bacillus Thuringiensis,” European Journal of Ophthalmology, Vol. 20, No. 1, 2010, pp. 243-245.
 J. C. de Vincnete-Rodrigez, “Maxillofacial Cellulites,” Medicina Oral, Patologia Oral y Cirugia Bucal, Vol. 9 2004, pp. 133-138.
 K. G. Smith, B. U. Ihle and W. J. Heriot, “Metastatic Endophthalmitis in Dialysis Patients,” American Journal of Nephrology, Vol. 15, No. 1, 1995, pp. 78-81.
 J. Cunha-Vaz, “The Blood-Ocular Barriers,” Survey of Ophthalmology, Vol. 23, No. 5, 1979, pp. 279-296.
 J. E. Grunwald, J. Alexander, M. Maguire, R. Whittock, C. Parker, K. McWilliams, J. C. Lo, R. Townsend, C. A. Gadegbeku, J. P. Lash, J. C. Fink, M. Rahman, H. Feldman, J. Kusek and A. Ojo, “CRIC Study Group, Prevalence of Ocular Fundus Pathology in Patients with Chronic Kidney Disease,” Clinical Journal of American Society Nephrology, Vol. 5, No. 5, 2010, pp. 867-873.
 M. J. Greenwald, L. G. Wohl and C. H. Sell, “Metastatic Bacterial Endophthalmitis: A Contemporary Reappraisal,” Survey of Ophthalmology, Vol. 31, No. 2, 1986, pp. 81-101. doi:10.1016/0039-6257(86)90076-7
 M. Engelbert, L. G. Miohl and C. H. Sell, ”Intravitreal Vancomycin and Amikacin versus Intravenous Imipenem in the Treatment of Experimental Staphylococcus Aureus Endophthalmitis,” Graefes Arch Clinical Experiment Ophthalmology, Vol. 242, No. 4, 2004, pp. 313-320.