1/9. 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 = 1keywords = extraction (Clic here for more details about this article) |
2/9. Enterococcal endophthalmitis following cataract extraction, treated with ampicillin intravitreally.A case of Enterococcal endophthalmitis developed following an extracapsular cataract extraction. The infection was successfully treated with intravenous and intravitreal ampicillin, but a secondary glaucoma led to a later enucleation. We report a case of postoperative endophthalmitis with an unusual etiology, which did not respond to common treatment.- - - - - - - - - - ranking = 5keywords = extraction (Clic here for more details about this article) |
3/9. Case of aortic endocarditis caused by lactobacillus casei.A case of Lactobacillus aortic valve endocarditis in a 53-year-old immunocompetent patient with past history of rheumatic fever is reported. Clinical symptoms began after a dental extraction and the patient's diet included several yogurts per day. blood, bone marrow cultures and the replaced aortic valve were positive for Lactobacillus: The clinical isolate was identified as lactobacillus casei by 16S rDNA sequencing.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
4/9. propionibacterium acnes endophthalmitis with bacterial sequestration in a Molteno's implant after cataract extraction.PURPOSE: To report a case of propionibacterium acnes endophthalmitis following uncomplicated cataract extraction with bacterial sequestration in a preexisting Molteno's drainage implant. DESIGN: Interventional case report. methods: A 7-year-old girl with congenital glaucoma and a preexisting Molteno's drainage implant developed anterior nongranulomatous uveitis 4 months following cataract surgery. P. acnes endophthalmitis was diagnosed by polymerase chain reaction, Southern blot, and electron microscopy. RESULTS: Extraction of the Molteno's implant was required to control the persistent intraocular inflammation and to convert the results of polymerase chain reaction and Southern blot testing of aqueous sample for P. acnes from positive to negative. CONCLUSION: P. acnes may be sequestered in glaucoma implants, potentially requiring implant removal to treat cases of P. acnes endophthalmitis.- - - - - - - - - - ranking = 5keywords = extraction (Clic here for more details about this article) |
5/9. propionibacterium acnes endophthalmitis after intracapsular cataract extraction.The authors report a case of propionibacterium acnes endophthalmitis after intracapsular cataract extraction with implantation of an anterior chamber intraocular lens. The patient's chronic inflammation persisted for 5 years after cataract surgery despite treatment with pars plana vitrectomy, intraocular lens removal, topical and oral steroids, and topical fortified antibiotics. Fluctuations in the inflammation were paralleled by changes in the size and appearance of a white plaque on the posterior corneal surface. anterior chamber tap cultures were positive for P. acnes after 8 days of incubation under anaerobic conditions. The inflammation was not controlled until the posterior corneal plaque, which was the presumed nidus of the chronic infection, was removed and the patient was treated with intravitreal and oral antibiotics.- - - - - - - - - - ranking = 5keywords = extraction (Clic here for more details about this article) |
6/9. cavernous sinus thrombosis following odontogenic and cervicofacial infection.cavernous sinus thrombosis (CST) is rarely seen clinically as a complication of infectious processes since the discovery of penicillin. At the present time, dental abscess is an uncommon cause of CST. We now report our experiences with a 60-year-old diabetic male, who developed CST 38 days after extraction of an infected upper third molar tooth. The importance of eradicating regional cervicofacial foci of infection is stressed.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
7/9. Posterior lens capsule abscess due to propionibacterium acnes and Staphylococcus epidermidis following extracapsular cataract extraction.A case of posterior lens capsular abscess occurring many months after an extracapsular cataract extraction is presented. This was caused by a mixed infection involving propionibacterium acnes and staphylococcus epidermidis. The significance of Staph epidermidis after such a long postoperative period is uncertain, but the case shows features typical of secondary endophthalmitis due to P acnes, including a long delay in onset and a grumbling course not brought under control by medical treatment. It supports the theory that the nidus of infection is localised in the posterior lens capsule by showing development of a visible capsular abscess with associated vitreous involvement. The subsequent removal of the capsule and vitreous, despite leaving the intraocular lens in place, led to complete resolution of the inflammation. Both organisms have previously been found to be sequestered in the posterior lens capsule by histological and microbiological examination of excised capsular specimens. It is important to consider them as possible causative agents in the formation of a postoperative capsular abscess.- - - - - - - - - - ranking = 5keywords = extraction (Clic here for more details about this article) |
8/9. Torulopsis candida (candida famata) endophthalmitis simulating Propionibacterium acnes syndrome.Four months after undergoing extracapsular cataract extraction with implantation of a posterior chamber intraocular lens, a 74-year-old woman developed granulomatous anterior uveitis. Although she initially responded well to corticosteroid therapy, she experienced multiple recurrences on discontinuation of this therapy. Slit-lamp examination showed the ocular inflammation to be associated with white cortical material within the lens capsular sac. She underwent removal of the implant as well as the lens capsular sac. Anaerobic culture yielded no organisms, but fungus cultures yielded Torulopsis candida. Histopathologic and electron microscopic studies showed large numbers of yeast sequestered within the lens capsular sac and mild granulomatous inflammation around the sac. Torulopsis candida is occasionally isolated from specimens as a contaminant, but has not yet been shown to produce human disease. The case reported herein documents potential pathogenicity of Torulopsis candida and reveals the importance of organisms other than anaerobic bacteria in causing delayed and localized intraocular inflammation that is virtually identical to propionibacterium acnes infection.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
9/9. Preliminary study of a new intraocular method in the diagnosis and treatment of propionibacterium acnes endophthalmitis following cataract extraction.Late endophthalmitis, due to propionibacterium acnes, developed in three patients following uncomplicated extracapsular cataract extraction and posterior chamber intraocular lens (PC-IOL) insertion. Cultures from the capsular bag yielded P. acnes in all three. With topical anesthesia and through an anterior chamber paracentesis, culture specimens were taken from and clindamycin irrigated into the capsular bag. Filtered 100% oxygen was introduced into the anterior chamber in two; the third also received an injection of gentamicin and dexamethasone into the capsular bag. After treatment, two patients received oral antibiotics; one received hyperbaric oxygen therapy. visual acuity was improved and inflammation reduced in all three. However, after treatment, ocular toxic effects due to clindamycin were suspected in one. This approach offers several clear advantages, including topical anesthesia, outpatient management, elimination of the need for vitrectomy, and retention of the intraocular lens (IOL).- - - - - - - - - - ranking = 5keywords = extraction (Clic here for more details about this article) |