Choroidal MRSA Abscess

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    • By Rui Zhang, BA
      Dartmouth, Geisel School of Medicine
      Co-author(s): Dimosthenis Mantopoulos, MD PhD (Dartmouth-Hitchcock Medical Center)
    • Uploaded on Apr 15, 2021.
    • Last modified by Caroline Bozell on Apr 15, 2021.
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    Appears in
    Choroidal MRSA Abscess
    Condition/keywords
    abscess, MRSA sepsis, acute leukemia
    Photographer
    Raymond Mok, CRA COMT (Dartmouth-Hitchcock Medical Center)
    Imaging device
    Fundus camera
    Optical coherence tomography
    Description
    A 14-year-old boy receiving induction chemotherapy for acute lymphocytic leukemia (ALL) complained of floaters and central scotoma in his left eye. (A) Fundus photography showed sub-macular choroidal abscess with intraretinal hemorrhage and edema. (B) OCT confirmed that the abscess had not penetrated the retinal pigment epithelium (RPE). Due to systemic septic signs (fever, tachycardia, tachypnea, new-onset papules), blood cultures were drawn and they came back positive for methicillin-resistant staphylococcus aureus (MRSA). Patient was promptly treated with both IV and intravitreal antibiotics. This is a case of sub-macular choroidal MRSA abscess in the setting of systemic bacteremia in an immunocompromised host.

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