1/9. 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 = motion (Clic here for more details about this article) |
2/9. Candidal endophthalmitis after keratoplasty.PURPOSE: To report a case of explosive fungal endophthalmitis after penetrating keratoplasty and to review additional published and unpublished cases to consider possible strategies for prevention. methods: Records of this patient with postkeratoplasty candidal endophthalmitis and previously reported cases of postkeratoplasty candidal endophthalmitis were reviewed. Additional information of 26 unpublished cases was obtained from the eye Bank association of America. RESULTS: After standard keratoplasty, the patient developed precipitous endophthalmitis on the second postoperative day. Abundant contamination with Candida was found in the residual donor corneoscleral rim, and candida albicans was isolated from the aqueous humor of the recipient. Despite therapy with local antimicrobial agents, intraocular amphotericin b, and systemic fluconazole, the patient had a poor outcome with hand-motion visual acuity. Of the 44 collected cases of postkeratoplasty candidal endophthalmitis, 40 (91%) had the same organism cultured from the donor rim or medium. Forty-three donor corneas had been preserved in cold storage medium at 4 degrees C. Of 15 cases in which the outcome was available, 9 (60%) resulted in visual acuity of 20/200 or worse. CONCLUSION: case reports confirm the occurrence of donor-to-host transmission of postkeratoplasty candidal endophthalmitis. Despite the low reported incidence, the poor prognosis of the affected eye in the ajority of these cases suggests the need for antifungal supplementation of cold preservation media and other preventative strategies.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
3/9. Late-onset corynebacterium endophthalmitis following laser posterior capsulotomy.Four months following uncomplicated cataract extraction, a patient underwent Nd:YAG laser posterior capsulotomy. Three days later, she presented with pain, hand motions vision, and severe anterior uveitis and vitritis. A coincident retinal detachment led to a delay in diagnosing the etiology of this intraocular inflammation. After recurrent episodes of inflammation that were initially responsive to corticosteroids, the patient underwent a vitrectomy, lens explantation, capsulectomy, and intravitreal antibiotic injections, which resulted in complete resolution of the intraocular inflammation with a best-corrected visual acuity of 20/60. corynebacterium species was ultimately cultured from the capsular tissue. The release of sequestered bacterial organisms must be considered in the differential diagnosis of persistent or unusually intense inflammation following laser posterior capsulotomy.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
4/9. Weak symptoms of bacterial endophthalmitis after a triamcinolone acetonide-assisted pars plana vitrectomy.PURPOSE: To report a case of endophthalmitis after triamcinolone acetonide (TA)-assisted par plane vitrectomy (PPV). methods: A 60-year-old Japanese man developed endophthalmitis after TA-assisted PPV for diabetic macular edema. Preoperative visual acuity was 20/200. Four days after surgery, endophthalmitis associated with anterior chamber hypopyon was noticed; the patient's vision had deteriorated to hand motion. In spite of severe cell infiltration, the ciliary injection and ocular pain were not significant. RESULTS: The additional PPV with irrigation of cefazolin (40 microg/ml) and gentamicin (8 microg/ml) was performed. endophthalmitis resolved soon after this treatment. staphylococcus epidermidis was detected in the intravitreous samples. The patient's visual acuity improved to 20/100. CONCLUSION: endophthalmitis may be a complication of TA-assisted PPV with unique signs and symptoms.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
5/9. endophthalmitis caused by klebsiella species.PURPOSE: To investigate clinical settings, antibiotic sensitivities, and visual outcomes associated with endophthalmitis caused by klebsiella species. DESIGN: Retrospective case series. methods: Record review of patients with endophthalmitis caused by klebsiella (1984 through 2003). RESULTS: Clinical settings included cataract surgery (one eye), trauma (two), perforated corneal ulcer (one), and endogenous associated with hepatic abscess (one). Pretreatment vision was hand motions or better in four eyes (80%). Initial treatment was enucleation (one eye), pars plana vitrectomy (two), and vitreous tap and injection (two); intravitreal antibiotics were administered to all nonenucleated eyes. klebsiella was sensitive to one or more antibiotics administered initially in all cases. In nonenucleated eyes, final acuity was >or=20/400 in two, 1/200 in one, and light perception in one. CONCLUSION: Despite treatment with appropriate antibiotics, endophthalmitis caused by klebsiella species is associated with generally poor visual outcomes.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
6/9. Good visual outcome after endophthalmitis in an eye previously treated successfully for amblyopia.A child with an extensive periorbital hemangioma developed an endophthalmitis caused by staphylococcus aureus after her second strabismus surgical procedure. Treatment with vitrectomy and intraocular antibiotics and steroid resulted in preservation of her eye. Despite previous successful treatment for amblyopia in that eye, her visual acuity improved from hand motion during the acute episode of endophthalmitis to 20/40 -2.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
7/9. candida albicans endophthalmitis after penetrating keratoplasty.We examined two patients who received contaminated corneas from the same organ donor during penetrating keratoplasty. Both developed candida albicans endophthalmitis, which responded to surgical and antifungal therapy. On follow-up examination one patient had a visual acuity of hand motions, a pupillary membrane, and a macular scar. The other had a visual acuity of 20/100 and a clear graft.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
8/9. An unusual case of cryptococcal endophthalmitis.BACKGROUND: Cryptococcal endophthalmitis is a rare disorder, almost invariably diagnosed after enucleation or at postmortem examination. There are therefore few guidelines as to its identification or treatment. methods: A case of culture-positive cryptococcal endophthalmitis in a patient with chronic uveitis was diagnosed by vitreous biopsy at the time of retinal detachment repair. The patient was treated with oral fluconazole for 5 months. All reported cases of cryptococcal endophthalmitis were reviewed and compared. RESULTS: After oral fluconazole therapy, the patient was culture negative on repeat tap. Despite conversion to culture-negative status, however, visual acuity declined to hand motions because of hyphema and hypotony. The organism was successfully identified as a non-neoformans species, cryptococcus laurentii, previously unreported as an ocular pathogen. CONCLUSION: This unique case demonstrates that cryptococcal disease can be diagnosed antemortem by vitreous biopsy, and should be added to the differential diagnosis in cases of chronic smoldering uveitis. A non-neoformans organism is also identified for the first time as a cause of ocular cryptococcosis. fluconazole, used here for the only time of which we are aware to treat cryptococcal endophthalmitis, produced successful conversion to culture negativity and resolution of the uveitis.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
9/9. endophthalmitis and orbital cellulitis after radial keratotomy.PURPOSE: To report the findings concerning three patients with endophthalmitis and one with panophthalmitis and orbital cellulitis radial keratotomy surgery. methods: One man referred with panophthalmitis and orbital cellulitis and three women referred with endophthalmitis were treated. RESULTS: After radial keratotomy surgery, during which no microperforation or macroperforation had been reported, a severe pseudomonas panophthalmitis and orbital cellulitis developed in the man. All vision was lost in that eye. staphylococcus epidermidis endophthalmitis developed in one woman, streptococcus pneumoniae endophthalmitis in the second woman and pseudomonas endophthalmitis in the third woman, after undergoing radial keratotomy procedures during which microperforations occurred. In the latter patient, bilateral simultaneous surgery was performed, but only one eye became infected. The latter two infections resulted in light perception and hand motion vision respectively. In three cases, an initial keratitis was located in the inferior cornea. CONCLUSIONS: Severe bacterial endophthalmitis can occur after radial keratotomy surgery, even in the absence of microperforation during the procedure. Any evidence of postoperative keratitis must be regarded seriously and treated aggressively. Despite use of this approach, the effect on final visual acuity can be devastating.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |