1/25. 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 = aureus (Clic here for more details about this article) |
2/25. 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 = 1keywords = aureus (Clic here for more details about this article) |
3/25. oxacillin-resistant staphylococcus aureus endophthalmitis after ganciclovir intraocular implant.PURPOSE: To describe a patient who developed oxacillin-resistant staphylococcus aureus endophthalmitis after insertion of a ganciclovir intraocular implant. METHOD: Case report. RESULTS: A 42-year-old man with acquired immunodeficiency syndrome (AIDS) and a history of cytomegalovirus retinitis was admitted with right-sided eye pain and decreased visual acuity 10 days after receiving a second ganciclovir intraocular implant in the right eye. A therapeutic vitrectomy, right eye, was performed on the day of admission. A vitreal tap produced frank pus and white, fluffy debris. Cultures of the vitreal fluid grew oxacillin-resistant S aureus, sensitive only to vancomycin, rifampin, and trimethoprim/sulfamethoxazole. The patient was successfully treated with removal of both ganciclovir implants in the right eye and a 4-week course of vancomycin and rifampin. However, the infection left the patient blind in the infected eye. CONCLUSION: Bacterial endophthalmitis is an infrequent but serious complication of the ganciclovir intraocular implant.- - - - - - - - - - ranking = 6keywords = aureus (Clic here for more details about this article) |
4/25. Simultaneous bacterial endophthalmitis and sympathetic uveitis after retinal detachment surgery.In a 66-year-old white woman suppurative endophthalmitis and sympathetic uveitis developed simultaneously about eight months after conventional repair of a rhegmatogenous retinal detachment. Histopathologic findings included vitreous abscess with probable staphylococcus organisms, total retinal detechment and diffuse chronic choroiditis with granulomatous foci, typical of sympathetic uveitis.- - - - - - - - - - ranking = 18.515107477628keywords = staphylococcus (Clic here for more details about this article) |
5/25. endophthalmitis after pediatric strabismus surgery.OBJECTIVE: To report 6 cases of endophthalmitis after pediatric strabismus surgery. methods: Retrospective review of initial signs, clinical findings, treatment, culture results, and visual and anatomical outcomes in 6 eyes of 6 children treated at 2 tertiary care institutions between 1983 and 1998. RESULTS: Four boys and 2 girls aged 8 months to 6 years (median age, 2 years) developed lethargy and asymmetric eye redness, with or without eyelid swelling or fever, within 4 days of surgery. At diagnosis (median, postoperative day 6) clinical findings included periorbital swelling, redness and leukocoria due to vitritis, and, in some cases, hypopyon. Treatment included pars plana vitrectomy and intravitreal and systemic antibiotics in all cases. Vitreous cultures grew streptococcus pneumoniae, haemophilus influenzae, and staphylococcus aureus. Within 6 months of strabismus surgery, visual acuity was no light perception in all eyes and 3 eyes had been enucleated. The 3 remaining eyes were prephthisical. CONCLUSIONS: endophthalmitis after pediatric strabismus surgery is rare. Children may not recognize or verbalize symptoms. Causative organisms are virulent. Visual and anatomical outcomes are poor. lethargy, asymmetric eye redness, eyelid swelling, or fever in the postoperative period, even if initial postoperative examination results are normal, should prompt urgent ocular examination. The diagnosis of endophthalmitis may be made when biomicroscopic or indirect ophthalmoscopic examination confirms the presence of vitreous opacification with or without hypopyon. Arch Ophthalmol. 2000;118:939-944- - - - - - - - - - ranking = 1keywords = aureus (Clic here for more details about this article) |
6/25. Case Report. Multiple etiology post-surgery endophthalmitis.The case describes a septic endophthalmitis arisen in a convalescence period following surgery of cataract extraction. The infection was due to staphylococcus aureus and three fungal components, candida albicans, candida glabrata and acremonium kiliense, which were subsequently isolated. A careful and prompt laboratory investigation allowed the clinicians to adjust the antimycotic therapy and attain an excellent clinical result.- - - - - - - - - - ranking = 1keywords = aureus (Clic here for more details about this article) |
7/25. iris abscess as an unusual presentation of endogenous endophthalmitis in a patient with bacterial endocarditis.PURPOSE: To report the clinical findings and management of a case of endogenous endophthalmitis in a patient with bacterial endocarditis presenting with a septic metastasis to the iris. DESIGN: Observational case report. methods: review of clinical findings and treatment. RESULTS: A 37-year-old intravenous drug user hospitalized with bacterial endocarditis secondary to methicillin-sensitive staphylococcus aureus bacteremia presented with a painful red left eye, hypopyon, and iris abscess. Roth spots were noted in the fundus of the right eye. Aqueous culture was positive for methicillin-sensitive S aureus. The patient was treated with intravitreal, topical, and intravenous antibiotics. The hypopyon and iris abscess resolved within 2 weeks, and the patient achieved a final visual acuity of 20/25 in the left eye. CONCLUSIONS: Septic metastasis to the iris is a rare occurrence. To our knowledge this is the first reported case of an iris abscess secondary to bacterial endocarditis.- - - - - - - - - - ranking = 2keywords = aureus (Clic here for more details about this article) |
8/25. Bilateral endogenous bacterial endophthalmitis: a report of four cases.PURPOSE: To present and discuss four cases of bilateral endogenous endophthalmitis. methods: An observational study of four patients aged 55-80 years, seen within a 2-year period. All had diagnostic and therapeutic vitrectomy. The antibiotic therapy was guided by analyses of cultures of blood and vitreous. RESULTS: blood cultures demonstrated streptococcus pneumoniae in two patients and staphylococcus aureus and morganella morganii, each in one patient. The findings corresponded with culture findings from vitreous material in two patients. The primary foci for the metastatic spread of infection were endocarditis, discitis and a subdural abscess of the lumbar spine, urinary tract infection, and infection of a recent hip alloplasty, respectively, in the four patients. Five eyes became blind, whereas three eyes recovered to visual acuity of 0.25-0.67. CONCLUSIONS: Endogenous bacterial endophthalmitis usually leads to total loss of vision. The disease is acute and the time span for intervention limited. We believe that an active therapeutic approach including intravitreal antibiotics and vitreoretinal surgery saved three eyes from blindness.- - - - - - - - - - ranking = 1keywords = aureus (Clic here for more details about this article) |
9/25. Acute postoperative endophthalmitis associated with dual strains of staphylococcus epidermidis.We report, to our knowledge for the first time, a dual-strain infection causing endophthalmitis. This case demonstrates the importance of sampling both anterior chamber and vitreous in all cases of endophthalmitis.- - - - - - - - - - ranking = 74.060429910511keywords = staphylococcus (Clic here for more details about this article) |
10/25. Mycotic infection of the capsular bag in postoperative endophthalmitis.A case of mycotic infection after uncomplicated extracapsular cataract extraction with implantation of a posterior chamber modified C-loop intraocular lens (IOL) is reported. Severe postoperative intraocular inflammation, diagnosed by aqueous cultures as secondary to staphylococcus aureus endophthalmitis, did not respond to antibiotic therapy. Despite IOL and capsular bag removal and further antibiotic treatment, the inflammation persisted and phthisis followed. Retrospective electron microscopic examination of the explanted material demonstrated the presence of abundant fungal elements in the capsular bag and spores on the IOL surface. Vitreous taps performed at the time of explantation were negative for bacteria and fungi, confirming the localized nature of the mycotic infection. To our knowledge this report represents the first observation of a mycotic infection confined to the capsular bag after cataract surgery with implantation of a posterior chamber IOL.- - - - - - - - - - ranking = 1keywords = aureus (Clic here for more details about this article) |
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