You will be presented with the full text of a biomedical research paper. Please write an abstract for this paper. Your response should include the abstract and no additional text.

Paper text:
a 72-year - old male patient with interstitial lung disease presented to a local clinic because of difficulty breathing and a subjective fever .
he had a fever of 39. the fever went down to 37 with the administration of antibiotics ; the patient was then given oral corticosteroids ( predinisolone 60 mg / day ) .
nine days after admission to a local clinic he developed blurred vision in both eyes ; however , ophthalmic examination was not performed initially .
three days after this decrease in visual acuity he was referred to our hospital . on initial examination ,
anterior segment examination revealed severe conjunctival injection , severe anterior chamber reaction without hypopyon , and mild complicated cataracts in both eyes .
fundus examination revealed a vitreal reaction and multiple whitish - yellow exudates in both eyes .
a single exudate was seen in the right macula and multiple exudates were observed in the left macula ( fig .
1 ) . we initially suspected a fungal infection , such as candida , given his history and fundus findings .
cytological examination and cultures of the blood , aqueous humor , and vitreous were ordered .
intravitreal vancomycin ( 1 mg ) , amikacin ( 200 g ) , and amphotericin b ( 5 g ) were then injected into both eyes .
oral ketoconazole ( 400 mg / day ) was given for the suspected ocular fungal infection . despite this treatment ,
five days after the initial intravitreal injection , visual acuity of the right eye had decreased to hand motion .
nine days after admission the patient underwent a pars plana vitrectomy with cataract surgery in the right eye .
intravitreal gentamicin ( 20 g / ml ) , cefazolin ( 50 g / ml ) , amphotericin b ( 1.0 g / ml ) , vancomycin ( 1 mg ) , and ceftazidime ( 2 mg ) were administered at the end of the surgery .
five days after the initial ocular presentation , p. agglomerans was identified in the vitreous culture , but the aqueous humor and blood cultures were negative . based on sensitivities , intravenous antibiotics ( ciprofloxacin 200 mg every twelve hours and ampicillin sodium 500 mg every eight hours ) were administered .
the inflammation of the right eye gradually decreased in response to this therapy , but no response was observed in the left eye . on hospital day 24
six months after surgery the patient 's final visual acuity improved to 25/20 in the right eye and 20/200 in the left eye .
an exudative scar of the paramacular area in his left eye was noted , but his symptoms were markedly improved .
endogenous bacterial endophthalmitis is a rare disease that occurs when microorganisms spread to the eye from a source elsewhere in the body , usually through the bloodstream .
it accounts for only 2 to 6% of all cases of endophthalmitis . in this case
we initially believed that the infection was fungal in origin because of the clinical features , no history of ocular trauma , the presence of interstitial lung disease with a fever , and the prior administration of immunosuppressive treatment .
early diagnosis and treatment were delayed and the inflammatory reaction worsened because this species of enterobacteriace is refractory to antifungal agents .
after aspiration of the vitreous , p. agglomerans was confirmed as the causative agent of the intraocular infection .
early detection of visual disturbances is important in patients who have received corticosteroids or immunosuppressive therapy .
p. agglomerans ( formerly named enterobacter agglomerans ) is a rare cause of endogenous endophthalmitis .
all species of the genus p. agglomerans can be isolated from feculent materials , plants , and soil ; they can be either pathogens or commensals . within the genus ,
p. agglomerans is the most commonly isolated species in humans , resulting in soft tissue or bone / joint infections following penetrating trauma by vegetation .
the organism also colonizes cotton and cotton plants and has been shown to cause a benign self - limited fever in intravenous drug abusers who filter drugs through cotton before injecting .
tissue toxicity associated with gram - negative rods in endophthalmitis is known to generally have a poor outcome . however , in our case the ocular infection subsided after vitrectomy , intravitreal injection , and tailored antibiotic treatment .
agglomerans produces yellow pigments that are typically only noticeable after delayed incubation at room temperature .
yellow pigment - producing colonies that were 2 mm in size , nonhemolytic , and convex were detected on a blood agar plate ( fig .
we believe that our case is the first report of bilateral endogenous endophthalmitis caused by p. agglomerans in korea and the first case reported outside of the united states .
we here in report a case of bilateral endogenous endophthalmitis caused by pantoea agglomerans ( p. agglomerans ) in a patient who had interstitial lung disease and was treated with oral corticosteroids . a 72-year - old man presented with decreased visual acuity in both eyes nine days after he received oral corticosteroids . 
 he had marked uveitis , cataracts , and vitreous opacities . 
 cultures were taken of blood , aqueous humor , and vitreous . 
 we initially suspected a fungal etiology and treated him with antifungal drugs ; however , the intraocular disease progressed without improvement . 
 vitreous culture was positive for p. agglomerans . 
 the patient underwent pars plana vitrectomy with cataract surgery bilaterally , followed by a 2-week course of antibiotics . 
 the final visual acuity was 20/25 in the right eye and 20/200 in the left eye . 
 this is the first report of bilateral endogenous endophthalmitis caused by p. agglomerans in korea ; it is also the first case reported outside of the united states .