Unusual sight-threatening complication of scaled burn injury in a pediatric patient: A case report

TL;DR

A 3-year-old child with a burn injury developed a rare eye infection called endopthalmitis, highlighting the need for early detection and treatment to prevent permanent vision loss.

Contribution

This case report highlights endopthalmitis as a rare but serious ophthalmic complication of burn injuries in children.

Findings

Bilateral endopthalmitis occurred in a pediatric burn patient without direct eye injury.

Prompt treatment improved symptoms and prevented permanent visual loss.

Risk factors included immune compromise, prolonged hospitalization, IV antibiotics, and young age.

Abstract

Acute ophthalmic complications in burn injury patients are rare. Despite their rarity however, when they do occur, they may result in permanent visual impairment and lifelong disability. Emphasizing the need for vigilance and prompt treatment initiation for a good outcome.

A 3-year-old girl was referred to our burn unit after receiving 10 days of treatment at a peripheral hospital for scalding burn to her upper chest, face, and scalp. Remarkably, her eyelids were spared from the initial injury. Upon her third day under our care, she began displaying severe sensitivity to light, photophobia, irritability, excessive crying, and frequent itching of the eyes. Upon examination, bilateral conjunctival redness and inflammation, as well as whitish opacity of both corneas with pus in the anterior chambers were observed. Prompt consultation and treatment led to improvement of the symptoms.

This case report describes a rare case of bilateral endopthalmitis in a burn injury patient with no initial apparent injury to the eyes and emphasizes the importance of vigilance, prompt recognition of the scenario and treatment initiation. Risk factors identified in this patient included compromised immune system due to severe burn, prolonged hospitalization, IV antibiotic use and young age. Other more common risk factors associated with endopthalmitis like direct ocular injury and central line use were absent making the case unusual.

Despite their rarity severe ophthalmic complications like endopthalmitis can occur in burn injury patients even when least expected. Heightened vigilance, prompt evaluation, multidisciplinary team approach and early initiation of broad spectrum antibiotic treatment is crucial to prevent permanent visual loss and lifelong disability.

•This report describes a rare case of bilateral endopthalmitis that occured in a pediatric patient who sustained burn injury.•Endopthalmitis as a rare ophthalmic complication of burn injury is entertained as an entity and implied as a complication of acute burn injuries.•Vigilance, prompt recognition of the scenario and treatment initiation is emphasized.

This report describes a rare case of bilateral endopthalmitis that occured in a pediatric patient who sustained burn injury.

Endopthalmitis as a rare ophthalmic complication of burn injury is entertained as an entity and implied as a complication of acute burn injuries.

Vigilance, prompt recognition of the scenario and treatment initiation is emphasized.

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