摘要
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.
