Kor J Ophthalmol Vol.21, No.1, 2007 Fig. 1A. Slit-lamp photograph at initial presentation: Severe corneal edema, hyphema, exudative membranes on anterior lens surface, and mid-dilated pupil. Fig. 2A. Slit-lamp photograph on the day 2 after intravitreal injections: Totally opaque cornea and inferior protrusion of the eyeball. Fig. 1B. B-scan ultrasonograph at initial presentation: Moderate vitreous opacities. Fig. 2B. B-scan ultrasonograph on the day 2 after intravitreal injections: Increased and condensed vitreous opacities. ml) and intravitreal antibiotic injections (vancomycin 1 mg/0.1 ml, ceftazidime 2 mg/0.1 ml) were performed with subsequent intravenous antibiotic therapy (Meropenem 2 g per day). Because of corneal haziness, it was impossible to treat the endophthalmitis surgically. Despite the intravitreal injections the anterior chamber reaction and ultrasonogram findings deteriorated, with inferior protrusion of the globe (Fig. 2). Intraocular Gram staining revealed 2+ gram-negative rods and 4+ Aeromonas hydrophila sensitive to ceftazidime by intraocular culture. Culture results from urine and bile juice were positive for Acinobacter Iwoffi/baumannii and Enterobacter aerogenes, respectively. However, blood culture results were negative for Aeromonas hydrophila. On day 8 after admission, percutaneous transhepatic biliary drainage was done to control total bilirubin, and on day 6 after intravitreal injections, limbus perforation occurred with extrusion of the intraocular contents (Fig. 3). Evisceration and MedporⓇ (porous polyethylene, Porex Surgical, College 46 Park, GA, U.S.A.) sphere implantation was done. On day 40 after admission, the patient was discharged from hospital with controlled jaundice, when her predicted survival was less than one year. D iscussio n Endogenous bacterial endophthalmitis is a rare but potentially sight-threatening condition that occurs when organisms reach the eye via the bloodstream and cross the blood-ocular barrier. It accounts for only 2-6% of all cases of endophthalmitis.3 Because prompt management is mandatory for saving the eye, clinicians must have a high index of suspicion of this rare but serious condition. Aeromonas species are important pathogens of fish and a variety of animals, and can be pathogenic in patients infected by a contaminated wound or in the immunocompromised. Aeromanas hydrophila has been reported to cause