1/295. Late bleb-related endophthalmitis after trabeculectomy with mitomycin C.To present two cases of delayed-onset postoperative endophthalmitis following trabeculectomy combined with mitomycin C for secondary glaucoma after penetrating keratoplasty. We retrospectively evaluated two patients with late endophthalmitis after trabeculectomy combined with intraoperative mitomycin C application. Both patients underwent trabeculectomy for uncontrolled glaucoma following penetrating keratoplasty and they developed thin-walled cystic blebs. intraocular pressure was normal, and grafts remained clear postoperatively. Severe endophthalmitis with hypopyon developed at 3 and 7 months postoperatively. Both patients had concomitant bleb infection. They underwent vitreous sampling and intravitreal injection of vancomycin and amikacin and were given topical fortified and systemic antibiotic therapy. Intravitreal injection was repeated once in both patients. Cultures grew streptococcus pneumonias in one and staphylococcus aureus in the other. Although the treatment of endophthalmitis was successful in both patients, only one of them achieved useful vision (20/40). For the other patient who had been infected with S. pneumoniae, vision was light perception. Delayed-onset endophthalmitis following trabeculectomy with mitomycin C application is a severe and vision threatening complication. It seems that the development of thin cystic filtering blebs secondary to intraoperative mitomycin C application may be a predisposing factor for bleb-related late endophthalmitis.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
2/295. 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 = infection (Clic here for more details about this article) |
3/295. Post-traumatic endophthalmitis: causative organisms and visual outcome.PURPOSE: Post-traumatic endophthalmitis makes up a distinct subset of intraocular infections. The purpose of the present study was to identify the causative organisms and record the visual outcome after infectious endophthalmitis in eyes with penetrating trauma. methods: We reviewed 18 consecutive cases of culture-positive endophthalmitis that developed after penetrating ocular trauma. All cases were treated with pars plana vitrectomy and intravenous and intraocular antibiotics. RESULTS: The 15 males and 3 females ranged in age from 4 to 43 years (mean 25.1 /- 11 years). Nine (50%) had intraocular foreign bodies. A single species was isolated in 16 cases, and multiple organisms in two. staphylococcus epidermidis and gram-negative organisms were the most frequent and were cultured either alone or in association with other organisms in respectively five (27.7%) and four cases (22.2%). clostridium perfringens was isolated in three cases (16.6%). bacillus was not found as a cause of endophthalmitis. Final visual acuity was better than 20/400 in eight cases (44%). In five cases (27.7%), the eye was saved but visual acuity was counting fingers. Two eyes (11%) had no light perception. The remaining three eyes (16.6%) were enucleated or eviscerated. clostridium perfringens was isolated from two eyes and aspergillus niger from one. Postoperative retinal detachment developed in four eyes, which were successfully operated. CONCLUSIONS: Organisms isolated in this series were similar to those in previous reports of post-traumatic endophthalmitis from other parts of the world, except that the frequency of clostridium perfringens isolation was high and no bacillus species were cultured. In view of its devastating outcome, post-traumatic endophthalmitis must be treated promptly with vitrectomy and intravitreal antibiotics.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
4/295. listeria monocytogenes-induced endogenous endophthalmitis in an otherwise healthy individual: rapid PCR-diagnosis as the basis for effective treatment.PURPOSE: listeria monocytogenes is a rare cause of endogenous endophthalmitis. To date 15 cases have been published in the literature. All eyes showed similar clinical features and profound visual loss mainly due to delayed diagnosis. methods: An additional case of an otherwise healthy 73 year-old male, who was referred to our hospital because of acute iridocyclitis with secondary glaucoma, is reported. Within a few days the severity of the intraocular infection increased dramatically, resulting in the clinical picture of acute endophthalmitis. RESULTS: In contrast to most published cases, early identification of the causative pathogen in the aqueous humor after anterior chamber puncture using polymerase chain reaction (PCR) and the initiation of a specific, systemic antibiotic medication, resulted in-complete recovery of visual acuity. CONCLUSIONS: PCR is very useful for the identification of the pathogen in intraocular infections.- - - - - - - - - - ranking = 2keywords = infection (Clic here for more details about this article) |
5/295. Simultaneous surgery for infective endocarditis and endophthalmitis.A 54-year-old woman was diagnosed as having septicemia secondary to infective endocarditis with aortic regurgitation which was complicated by endophthalmitis. Her septicemia was controlled by intravenous antibiotic therapy. Then the localized eye infection and the aortic regurgitation with a massive vegetation were surgically treated simultaneously. She had no relapse of infection after intensive postoperative antibiotic therapy.- - - - - - - - - - ranking = 2keywords = infection (Clic here for more details about this article) |
6/295. Use of a low nutrient culture medium for the identification of bacteria causing severe ocular infection.A low nutrient culture medium was used to identify the pathogens in four cases of persisting ocular infection. Bacto R2A agar was used in addition to conventional liquid- and solid-phase media to culture pathogenic bacteria from one case of recurrent keratitis, one case of suture-related keratitis with endophthalmitis and two eyes (two patients) with post-operative endophthalmitis. In each case, a pathogen was identified solely with R2A agar after culture for 6 days. Species isolated were pseudomonas aeruginosa (one), propionibacterium acnes (two) and staphylococcus aureus (one). Antibiotic therapy was tailored to conform to the sensitivity of the cultured organism in each case. The use of Bacto R2A low nutrient agar should be considered in culture negative eyes not showing clinical improvement, or for chronic cases where bacteria may have become adapted to more stringent ocular environments.- - - - - - - - - - ranking = 5keywords = infection (Clic here for more details about this article) |
7/295. Pseudomonas-induced bilateral endophthalmitis with corneal perforation in a neonate.Neonatal endophthalmitis is a rare entity that may be exogenous or endogenous. pseudomonas aeruginosa is a ubiquitous gram-negative rod that may appear as a nosocomial source of infection in the neonatal intensive care unit. A case of bilateral Pseudomonas-induced endophthalmitis is presented, and a discussion of the case and of the relevant literature follows.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
8/295. Endogenous endophthalmitis: case report and brief review.Endogenous endophthalmitis is a potentially blinding ocular infection resulting from hematogenous spread from a remote primary source. The condition is relatively rare but may become more common as the number of chronically debilitated patients and the use of invasive procedures increase. Many etiologic organisms (gram-positive, gram-negative and fungal) have been reported to cause endogenous endophthalmitis. risk factors are well defined and include most reasons for immune suppression. A high clinical suspicion is needed for early diagnosis and treatment. Early intravenous antibiotic therapy remains the cornerstone of treatment. The roles of intravitreal antibiotics and vitrectomy are evolving and may become more widely accepted as therapeutic modalities. The authors report a case of endogenous endophthalmitis and provide a brief review of the literature.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
9/295. Serious infections from bacillus sp.Serious infections caused by organisms of the genus bacillus developed in seven patients. Five drug abusers had either endocarditis or osteomyelitis, one leukemic patient had necrotizing fasciitis, and one patient had a ventriculoatrial shunt infection with recurrent bacteremia. All patients recovered. Experience with these cases reemphasizes the importance of not dismissing bacillus organisms as culture contaminants, especially when isolated from blood, body fluids, or closed-space infections.- - - - - - - - - - ranking = 7keywords = infection (Clic here for more details about this article) |
10/295. endophthalmitis from mycobacterium bovis-bacille Calmette-Guerin after intravesicular bacille Calmette-Guerin injections for bladder carcinoma.PURPOSE: To present clinical and histologic findings of intraocular infection with mycobacterium bovis-bacille Calmette-Guerin after intravesicular bacille Calmette-Guerin injections for treatment of bladder carcinoma. methods: A 77-year-old man was initially seen with visual acuity of 20/200, focal retinitis, vasculitis, and progressive vitreous opacity in the right eye and visual acuity of light perception, intraocular inflammation, and a dense cataract in the left eye 14 months after intravesicular injection of live bacille Calmette-Guerin organisms. RESULTS: Vitreous cultures in the right eye demonstrated growth of bacille Calmette-Guerin organisms. Bilateral loss of light perception occurred despite systemic antimy-cobacterial therapy. Histopathologic examination demonstrated nongranulomatous inflammation and acid-fast bacilli in both eyes. CONCLUSION: Delayed endogenous endophthalmitis may develop after intravesicular bacille Calmette-Guerin injection that may not respond to systemic agents. Intravitreal therapy may be indicated.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
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