Fulminant Eye Infection in a Patient With Nephrotic Syndrome: A Case Report

TL;DR

A patient with kidney disease and weakened immunity suffered a severe eye infection that led to serious complications despite treatment.

Contribution

Highlights the challenges of managing severe eye infections in immunocompromised patients with nephrotic syndrome.

Findings

Topical antibiotics and steroids failed to prevent corneal perforation in a patient with nephrotic syndrome.

Compromised renal function and anemia limited surgical options for treating the eye infection.

Early recognition and aggressive antimicrobial therapy are critical in preventing severe ocular complications.

Abstract

This case report presents the clinical course of a 53-year-old male farmer with nephrotic syndrome, specifically focal segmental glomerulosclerosis, who developed a fulminant eye infection. While receiving maintenance hemodialysis and immunosuppressive therapy, the patient presented with sudden onset redness, discharge, and decreased vision in his right eye. Initial management with topical antibiotics and steroids failed to halt the progression of the infection, leading to corneal perforation and iris prolapse within a few days. Despite the discontinuation of immunosuppressive medications and initiation of broad-spectrum antimicrobial therapy, the patient's compromised renal function and anaemia precluded surgical intervention. This case underscores the challenges in managing severe ocular infections in immunocompromised patients. It highlights the importance of early recognition, aggressive antimicrobial therapy, and close ophthalmologic monitoring in preventing sight-threatening complications. Despite intensive management, the prognosis for visual recovery in such cases may be poor, emphasizing the need for preventive strategies and careful surveillance in high-risk patient populations.

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