HJ Sohn, et al. ENDOGENOUS AEROMONAS HYDROPHILA ENDOPHTHALMITIS Fig. 3A. Slit-lamp photograph on the day 6 after intravitreal injections: Perforation of the eyeball. endophthalmitis after a penetrating injury,4 post-traumatic keratitis,5 contact lens-related keratitis,6 and endogenous endophthalmitis.1,2 The presence of many RBCs in the anterior chamber is not typical of endophthalmitis, and has not been found in other reported cases of Aeromonas hydrophila.1,2 However, in the present case we found hyphema. Although our patient was not overtly immunocompromised, risk factors such as old age, diabetes, hypertension, and malignancy may have predisposed a state of immune dysfunction. The patient had distal common bile duct carcinoma with obstructive jaundice, but the exact source of the infecting organism remains unclear. It is possible that Aeromonas hydrophila was contracted from a long indwelling catheter rather than direct spread from biliary sepsis. In common with two previous reports,1,2 this case also showed a rapidly worsening course and a poor prognosis despite prompt diagnosis and management. Fig. 3B. Computed tomograph on the day 6 after intravitreal injections: Contracted right eyeball with internal increased densities. References 1. Frieling JS, Rosenberg R, Edelstein M, et al. Endogenous Aeromonas hydrophila endophthalmitis. Ann Ophthalmol 1989;21:117-8. 2. Tamura T, Hida T. A case of endogenous Aeromonas hydrophila endophthalmitis. Nippon Ganka Gakkai Zasshi 2003;107:535-7. 3. Jackson TL, Eykyn SJ, Graham EM, Stanford MS. Endogenous bacterial endophthalmitis: a 17-year prospective series and review of 267 reported cases. Surv Ophthalmol 2003;48:403-23. 4. Cohen KL, Holyk PR, McCarthy LR, Peiffer RL. Aeromonas hydrophila and Plesiomonas shigelloides endophthalmitis. Am J Ophthalmol 1983;96:403-4. 5. Feaster FT, Nisbet R, Barber JC. Aeromonas hydrophila corneal ulcer. Am J Ophthalmol 1978;85:114-7. 6. Carta F, Pinna A, Zanetti S, et al. Corneal ulcer caused by Aeromonas species. Am J Ophthalmol 1994;118:530-1. 47