Endogenous Endophthalmitis

A 57-year-old man who had end-stage renal disease was admitted to the hospital because of infection of a left-upper-extremity fistula. Vancomycin was started empirically, and blood cultures grew methicillin-resistant Staphylococcus aureus . Several days after admission, he reported new pain, redness, and decreased visual acuity in his right eye. Visual acuity was assessed by the ability to count the number of fingers held up by the examiner at a distance of 10 in. (25 cm). Visual inspection revealed marked subconjunctival hemorrhage (short arrow) and a small hypopyon (long arrow). Ophthalmologic examination showed vitreous debris and retinal traction, which were consistent . . .