A Triple Threat: Staph Aureus Bacteraemia Leading to Endophthalmitis, Atypical Lung Infection, and Epidural Abscess

We are presenting a case of 74 years old gentleman who had a robotic cystoprostatectomy with ileal conduit and subsequently developed complicated Staphylococcus bacteraemia. His post operative recovery was slightly delayed due to paralytic ileus. Three days post discharge he represented himself with features of thrombophlebitis of forearm and septic shock requiring admission to intensive care. This was complicated with loss of vision and new onset neurological symptoms including quadriplegia. Subsequent investigations confirmed Staphylococcus bacteraemia leading to atypical lung infection, endophthalmitis and epidural abscess. He required intra-vitreal injection of antibiotics and decompression of epidural abscess twice. He completed a total of 6 weeks of IV antibiotics. Although, his vision and upper limb function have improved, he remains paraplegic. Staphylococcus aureus can cause wide range of infection leading to serious complications in immunocompromised patients. In our case, the only identifiable source of the infection was the patient’s peripheral venous cannulation site which is very unusual.