1/8. 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) |
2/8. 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) |
3/8. Subdural empyema after tooth extraction in which capnocytophaga species was isolated.We describe a patient with meningitis and a subdural empyema arising from an infection after teeth extraction in which capnocytophaga species was detected. The patient was a 54-y-old man without any underlying diseases. A computerized tomography scan showed a subdural empyema 21 d after the extraction.- - - - - - - - - - ranking = 1.2keywords = extraction (Clic here for more details about this article) |
4/8. capnocytophaga canimorsus endophthalmitis following cataract surgery.An elderly man developed endophthalmitis 1 week after cataract extraction and lens implantation. Intraocular samples were collected and the patient received intravitreal vanco-mycin and ceftazidime, and topical tobramycin. A Gram stain of vitreous humour revealed spindle-shaped Gram-negative bacilli. He was then given systemic clindamycin and topical ofloxacin. capnocytophaga canimorsus, a member of the oral flora of dogs and cats, was cultured after 3 days. The infection resolved leaving the patient with a visual acuity of 6/60. An attempt was made to culture the organism from the mouth of the patient's pet dog. This was unsuccessful and the source of the infection remains unknown.- - - - - - - - - - ranking = 0.2keywords = extraction (Clic here for more details about this article) |
5/8. rhizobium (agrobacterium) radiobacter identified as a cause of chronic endophthalmitis subsequent to cataract extraction.Herein, we report a case of chronic endophthalmitis caused by a ceftazidime-resistant rhizobium radiobacter strain in a 62-year-old male. The patient underwent an uneventful cataract extraction of the right eye a week prior to the appearance of symptoms (pain, redness, and blurring vision) which developed following a golf outing. Upon admission the patient received an emergency vitrectomy. The patient remained symptomatic, and R. radiobacter was isolated repeatedly from vitreous fluid cultures over a 5-month period. Ultimately, the infection responded to intravitreal gentamicin, oral ciprofloxacin, and removal of the lens implant.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
6/8. stenotrophomonas maltophilia endophthalmitis after cataract extraction.PURPOSE: To report the clinical course, treatment response, and prognosis of stenotrophomonas maltophilia endophthalmitis following cataract extraction. methods: The clinical records of six cases of S. maltophilia endophthalmitis after cataract extraction were retrospectively reviewed. Data were collected for surgical characteristics, disease course, culture growth, antibiotic sensitivity of the pathogen, response to treatment, and final visual acuity. RESULTS: Four patients underwent uncomplicated cataract extraction with phacoemulsification (PHACO) and intracapsular intraocular lens (IOL) implantation. One case was complicated by inadvertent posterior capsular tear during PHACO and IOL implantation. One patient underwent a combined extracapsular cataract extraction (ECCE) with IOL implantation and trabeculectomy, but vitrectomy was also performed because of cortical material loss into the vitreous cavity after a capsular tear. Symptoms began between postoperative days 1 and 19. All patients underwent a vitreous tap and intravitreal injections of antibiotics. Medical therapy alone was sufficient in five patients to treat the infection. One patient had four episodes of recurrence. Pars plana vitrectomy with subsequent capsulectomy and IOL extraction were performed in this patient to complete remission. CONCLUSION: S. maltophilia should be considered a pathogenic organism possibly causing endophthalmitis after PHACO IOL implantation. The clinical picture resembles acute bacterial endophthalmitis. When the pathogen has settled in the capsular bag, the infection may persist and become refractory to medical treatment.- - - - - - - - - - ranking = 1.8keywords = extraction (Clic here for more details about this article) |
7/8. xanthomonas maltophilia endophthalmitis after cataract extraction.PURPOSE: To report a case of xanthomonas maltophilia endophthalmitis and to increase awareness of its potential as an intraocular pathogen. METHOD: Case report. RESULTS: A 76-year-old woman developed X maltophilia endophthalmitis after cataract extraction. To eradicate the infection, we performed two vitrectomies and treated the patient with numerous intravitreal antibiotic injections. CONCLUSIONS: X maltophilia is a potential intraocular pathogen in an immunocompetent host. If the infection takes a persistent course, persistent topical and intravitreal antibiotic treatment and possibly vitrectomy are needed to eradicate the infection.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
8/8. Antibody response in six HACEK endocarditis cases under therapy.The antibody response to bacteria of the so-called HACEK group, i.e. Haemophilus spp., actinobacillus actinomycetemcomitans, cardiobacterium hominis, eikenella corrodens and kingella kingae, was measured in sera of six patients with endocarditis. The corresponding isolates from their blood cultures were identified by conventional methods, including reactions for nitrate reduction and catalase as well as acid production from sugars. Crude antigens were prepared by glycine extraction and sonification of the blood culture isolates, and used to determine titers by complement fixation. A patient with haemophilus parainfluenzae bacteremia received a short course of antibiotic therapy, and relapsed with spondylitis and endocarditis 5 months later. Titers of sera against his own isolate rose from 1:40 to 1:320 and fell to 1:40 after therapy within one year. A patient with C. hominis endocarditis had a similarly prolonged course. The complement fixation titer against his own isolate was already 1:240 before antibiotics were administered. Another patient with C. hominis endocarditis presented a titer of 1:320 2 weeks after the diagnosis. These three patients revealed c-reactive protein values over 50 mg/l in the first serum sample. Decrease of both antibody titers and c-reactive protein values correlated with clinical improvement. Two patients with prosthetic valve replacement 5 months earlier developed C. hominis and K. kingae endocarditis, respectively. At admission, c-reactive protein values were 64 and 82, respectively, and therapy was instituted immediately. The first sera were received 3 and 6 weeks, respectively, after isolation of the corresponding blood culture isolates and revealed already low titers, i. e. 1:80 and 1:60, respectively. A woman with A. actinomycetemcomitans endocarditis received immediate therapy and did not develop titers against her own isolate. CRP was 100 at admission and remained over 50 5 weeks later. We conclude that the complement fixation assay with individual antigen preparations was easy to perform and allowed monitoring of the antibody response in 5 of 6 HACEK endocarditis cases under therapy, but the usefulness of this method to find culture-negative HACEK endocarditis needs to be established.- - - - - - - - - - ranking = 0.2keywords = extraction (Clic here for more details about this article) |