Endogenous endophthalmitis: microorganisms, disposition and prognosis
Endogenous endophthalmitis: microorganisms, disposition and prognosis
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DOI：
10.1111/j.1600-0420.2007.00982.x
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发表时间：
2007-12-01
期刊：
影响因子：
--
通讯作者：
Hansen, Lutz Lothar
中科院分区：
文献类型：
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作者：
Ness, Thomas;Pelz, Klaus;Hansen, Lutz Lothar
目的：内源性眼内炎是一种由微生物血行传播引起的严重且可能致盲的并发症。我们评估了该疾病的致病微生物、倾向和预后。方法：1996 年至 2006 年间，对 28 名患有内源性眼内炎的患者的 31 只眼睛进行了治疗。结果：在所有接受调查的眼睛中，94% 的眼睛中可鉴定出引起感染的微生物。在研究的 29 只眼睛中，有 15 只眼睛分离出念珠菌，11 只眼睛分离出革兰氏阳性菌，1 只分离出革兰氏阴性菌，两只眼睛分离出曲霉菌。大多数患者患有严重的全身疾病（免疫缺陷、严重的外科手术、糖尿病），三分之一是静脉注射药物滥用者。只有一名患者身体健康。预后取决于致病微生物。而念珠菌感染的眼睛没有一只失明，除了两只患有革兰氏阳性菌、诺卡氏菌或曲霉感染的眼睛外，所有眼睛均丧失视功能或不得不摘除眼球。结论：与术后眼内炎相比，内源性眼内炎患者更容易感染念珠菌。视力预后主要取决于潜在的微生物，在革兰氏阳性菌或曲霉菌感染的情况下，视力预后尤其差。
Purpose: Endogenous endophthalmitis is a severe and potentially blinding complication caused by haematogenous spreading of microorganisms. We evaluated the causative microorganisms, disposition to and prognosis of the disease.Methods: Thirty-one eyes of 28 patients were treated between 1996 and 2006 as the result of an endogenous endophthalmitis.Results: The microorganisms responsible for infection could be identified in 94% of all eyes investigated. Candida isolates were obtained in 15, gram-positive isolates in 11, gram-negative in one and Aspergillus in two of the 29 eyes studied. The majority of patients suffered from severe general disease (immuno-deficiency, severe surgical procedures, diabetes mellitus) and one third were intravenous drug abusers. Only one patient was otherwise healthy. The prognosis depended on the causative microorganisms. Whereas none of the eyes with Candida infection became blind, all except two of the eyes with gram-positive bacteria, Nocardia or Aspergillus infection lost visual function or had to be enucleated.Conclusion: Compared to postoperative endophthalmitis, patients with endogenous endophthalmitis are more likely to have Candida isolates. Visual prognosis depends mainly on the underlying microorganisms, and is particularly poor in the case of infection with gram-positive bacteria or Aspergillus.