Endogenous endophthalmitis secondary to hematogenous dissemination from a diabetic foot.

Abstract

Case presentation. We present the case of a woman with a history of poorly controlled diabetes mellitus, who sought emergency care due to discoloration and discharge in her left foot, along with systemic symptoms such as vomiting and fever. Physical examination revealed signs of severe infection in her previously amputated left foot and findings suggestive of endophthalmitis in her right eye. Radiological studies showed subcutaneous gas and osteolysis in the metatarsal bones. Empirical antibiotic therapy and metabolic management were initiated. Treatment. During hospitalization, the patient required abscess drainage in the left foot and, later, infracondylar amputation of the left lower limb due to infection progression. Ocularly, she developed blindness and severe inflammatory signs; orbital computed tomography confirmed endogenous endophthalmitis, which was treated with evisceration of the right eye. Outcome. In the immediate postoperative period, the patient had a favorable evolution, without signs of active infection at the surgical sites. Microbiological cultures from both the foot and the eye identified Streptococcus agalactiae as the etiological agent. This case highlights the importance of early diagnosis, timely surgical intervention, and multidisciplinary management to prevent fatal complications in immunocompromised diabetic patients.