We present a case of postseptal cellulitis caused by a rare combination of organisms in an immunocompetent patient following ocular trauma from brackish water. A 23-year-old healthy female sustained a penetrating eye injury while fishing in brackish water. Imaging revealed a retained wooden foreign body in the postseptal space. Surgical intervention included orbitotomy, foreign body removal, and drain placement. Intraoperative cultures identified Aeromonas species, Edwardsiella tarda , Escherichia coli , and an unspecified mold. The patient was treated with broad-spectrum antibiotics and 6 weeks of voriconazole once fungal elements were detected, with full resolution of infection. This case highlights the importance of thorough history-taking to determine specific exposures to infectious agents and consideration of unusual pathogens associated with brackish water exposure.
Commaroto et al. (Thu,) studied this question.