1/87. alcaligenes xylosoxidans endophthalmitis 8 months after cataract extraction.PURPOSE: To report a case of alcaligenes xylosoxidans endophthalmitis and to increase awareness of its potential as an intraocular pathogen. methods: An 80-year-old woman in good general health developed A. xylosoxidans endophthalmitis 8 months after an uncomplicated cataract extraction performed at another institution. Eventually, vitrectomy with removal of the intraocular lens and capsule was performed because of recurrent disease after intravitreal antibiotic injections. RESULTS: Microbiologic examination of the vitreous biopsies and capsule disclosed A. xylosoxidans, a motile, gram-negative rod resistant to many antibiotics. CONCLUSION: A. xylosoxidans should be considered as a cause of low-grade endophthalmitis after cataract surgery.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
2/87. A case of an intraocular foreign body due to graphite pencil lead complicated by endophthalmitis.We report a case of an 8-year-old boy who presented with an intraocular foreign body composed of graphite pencil lead. The patient had been accidentally poked in the right eye with a graphite pencil. Primary care consisted of corneal suturing and lens extraction. Two pieces of the pencil lead remained in the vitreous cavity following surgery, and 2 days later the patient developed endophthalmitis. Pars plana vitrectomy was performed immediately and the intraocular foreign bodies were removed through the scleral wound. Cultures of the vitreous fluid revealed no bacterial organisms. X-ray fluoroscopic analysis of the vitreous detected 1 ppm of aluminum (a constituent of the pencil lead). Although the clinical presentation indicated probable bacterial endophthalmitis, the detection of elemental aluminum within the vitreous cavity also suggested the possibility of further retinal toxicity due to some dissolving of the pencil lead.- - - - - - - - - - ranking = 0.2keywords = extraction (Clic here for more details about this article) |
3/87. abiotrophia species as a cause of endophthalmitis following cataract extraction.Microorganisms of the genus abiotrophia, members of the oral flora, are known as important causes of bacterial endocarditis. In this study, we report two individual cases of acute vitreous infection caused by abiotrophia adiacens and abiotrophia defectiva approximately a week after cataract extraction. abiotrophia isolates were recovered by cultivation of vitreous humor on chocolate agar and identified via conventional and API 20 Strep identification systems. An 83-year-old male patient (A) and an 80-year-old female patient (B) demonstrated almost identical symptoms of infectious endophthalmitis manifested as hypopyon and opaque media. The vision of both patients was reduced to detection of hand motion in the left and the right eyes, respectively. An emergency pars plana core vitrectomy was performed, and intraocular antibiotics were administered to each patient, who presented 8 months apart in two different institutions. patients A and B were treated with an intravitreal injection of vancomycin-amikacin and vancomycin-ceftazidime, respectively, which resulted in complete recovery.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
4/87. Preretinal haemorrhages: an unusual manifestation of intravitreal amikacin toxicity.PURPOSE: To report a case with multiple preretinal haemorrhages after intravitreal amikacin. METHOD: A 58-year-old patient developed postoperative endophthalmitis following a routine extracapsular cataract extraction in his left eye. He received two intravitreal injections of cephazoline (2.25 mg) and amikacin (0.4 mg), given 48 h apart. RESULTS: The patient presented to us with large preretinal haemorrhages at the posterior pole. Multiple large areas of blocked fluorescence were seen on fundus fluorescein angiography. CONCLUSION: Widespread posterior pole preretinal haemorrhages may be an unusual manifestation of intravitreal amikacin toxicity.- - - - - - - - - - ranking = 0.2keywords = extraction (Clic here for more details about this article) |
5/87. Postoperative endophthalmitis caused by sequestered acinetobacter calcoaceticus.PURPOSE:To describe postoperative endophthalmitis caused by sequestered acinetobacter calcoaceticus.METHOD:Case report. A 40-year-old woman developed recurrence of inflammation after extracapsular cataract extraction with intraocular lens (IOL) implantation. At last recurrence, the capsular bag was studded with white deposits. Intraocular lens was removed along with capsular bag during pars plana vitrectomy.RESULTS:The capsular bag, when cultured, grew A calcoaceticus. The media remained clear with no evidence of recurrence of infection over a 3-month follow-up. CONCLUSION:Postoperative endophthalmitis similar to that caused by sequestered propionibacterium acnes can be caused by A calcoaceticus.- - - - - - - - - - ranking = 0.2keywords = extraction (Clic here for more details about this article) |
6/87. Early acute aseptic iritis after cataract extraction.Severe iritis which occurs within the first five days after cataract extraction may be categorized as (1) bacterial endophthalmitis, (2) toxic iritis, or (3) aseptic iritis. These entities can sometimes be distinguished because of their clinical features. If bacterial endophthalmitis is suspected, anterior chamber paracentesis should be considered and appropriate antibiotic treatment should be initiated. Acute iritis may result from the introduction of toxic agents into the eye, and may follow the use of products sterilized with ethylene oxide. Early acute aseptic iritis probably occurs more often than has previously been recognized. Response to intensive anti-inflammatory treatment is usually prompt and dramatic. The judicious use of cryoextraction and the careful manipulation of intraocular tissues may minimize the incidence and the severity of postoperative inflammation.- - - - - - - - - - ranking = 1.2keywords = extraction (Clic here for more details about this article) |
7/87. Traumatic endophthalmitis caused by an erwinia species.A previously healthy 70-year-old white man sustained a plant injury to his left eye while gardening and was admitted here because of an ensuing perforated cornea and endophthalmitis. The lens was opaque and its anterior capsule was ruptured. culture of fluid obtained by anterior chamber paracentesis yielded a species of the erwinia herbicolalathyri group (enterobacter agglomerans). Thirty-seven days after a course of cefazolin and gentamicin therapy, corneal edema necessitated a planned extracapsular cataract extraction. The aqueous humor and lens again revealed the identical erwinia species in pure culture. The patient received another course of cefazolin and showed improvement after the lens aspiration.- - - - - - - - - - ranking = 0.2keywords = extraction (Clic here for more details about this article) |
8/87. Intravitreal antibiotic injection and vitrectomy in acute bacterial endophthalmitis.Two days after an unplanned extra-capsular cataract extraction with sector iridectomy, a patient showed typical signs of bacterial endophthalmitis. Vitreous and aqueous were aspirated for culture, and gentamicin and dexamethasone were injected. Twenty-four hours later, after isolation of staphylococcus epidermidis, a vitrectomy to remove the central vitreous was done. Postoperatively, vision progressively improved; at the last review nine months after vitrectomy, visual acuity was 20/50.- - - - - - - - - - ranking = 0.2keywords = extraction (Clic here for more details about this article) |
9/87. Postoperative mycobacterium chelonae endophthalmitis after extracapsular cataract extraction and posterior chamber intraocular lens implantation.OBJECTIVE: To describe a case of postoperative endophthalmitis caused by mycobacterium chelonae after extracapsular cataract extraction with posterior chamber intraocular lens implantation. DESIGN: Interventional case report. methods: The history and clinical presentation of a 66-year-old female patient, in whom a low-grade delayed-onset endophthalmitis and keratitis developed after extracapsular cataract extraction with posterior chamber intraocular lens implantation, is described. Microbiologic investigations of the scrapings of corneal infiltrate at the cataract incision site, aqueous humor and eviscerated material, and histopathologic study of eviscerated material and an enlarged cervical lymph node were performed. MAIN OUTCOME MEASURES: The clinical, histopathologic, and microbiologic findings in a case of low-grade delayed-onset endophthalmitis. RESULTS: Analysis of the direct smear of both the corneal infiltrate as well as the eviscerated material revealed acid-fast bacilli. M. chelonae was isolated from these specimens. Direct smear and culture of the aqueous humor were negative for bacteria (including mycobacteria) and fungus. Histopathologic examination of the eviscerated material showed a dense infiltration of polymorphonuclear leukocytes in the uveal tissue, extensive necrosis and hemorrhage, and exudates with hemorrhage in the vitreous cavity. Histopathologic examination of the lymph node revealed granulomatous inflammation with caseation necrosis, but did not reveal acid-fast bacilli. CONCLUSIONS: M. chelonae, although infrequent, should be considered an etiologic agent of delayed-onset, postoperative endophthalmitis and early bacterial diagnosis should help in institution of appropriate therapy.- - - - - - - - - - ranking = 1.2keywords = extraction (Clic here for more details about this article) |
10/87. alcaligenes xylosoxidans and propionibacterium acnes postoperative endophthalmitis in a pseudophakic eye.PURPOSE: To report a case of persistent polymicrobial postoperative endophthalmitis caused by alcaligenes xylosoxidans and propionibacterium acnes in a pseudophakic eye. A. xylosoxidans is a gram-negative bacteria resistant to most antibiotics. methods: Case report. RESULTS: A 72-year-old man presented with clinical signs of endophthalmitis on the first postoperative day after a phacoemulsification procedure with posterior chamber intraocular lens, left eye. Initial treatment included topical, subconjunctival, and oral antibiotics. After initial clearing, there was recrudescence of infection on postoperative day 37 that prompted referral of the patient to the Cullen eye Institute. Treatment at that time included anterior chamber and vitreous taps with intravitreal antibiotic injections. Complete pars plana vitrectomy and intraocular lens explantation were eventually required because of persistent infection with a resistant organism. Cultures from the first procedure grew A. xylosoxidans and P. acnes. Cultures from the vitrectomy grew only A. xylosoxidans. At the final follow-up visit 6 months after the initial procedure. The eye was without inflammation with best-corrected visual acuity of 20/40. CONCLUSION: Both A. xylosoxidans and P. acnes can cause chronic progressive endophthalmitis after cataract extraction often resistant to corrective antibiotic therapy. Successful intervention may require complete vitrectomy with intraocular lens and capsule removal.- - - - - - - - - - ranking = 0.2keywords = extraction (Clic here for more details about this article) |
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